Provider Demographics
NPI:1598152092
Name:AIELLO, JESSICA L
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:AIELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:PARTRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, NCC, AACC
Mailing Address - Street 1:6232 BANKERS RD LOWR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53403-9747
Mailing Address - Country:US
Mailing Address - Phone:605-641-0566
Mailing Address - Fax:
Practice Address - Street 1:6232 BANKERS RD LOWR
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53403-9747
Practice Address - Country:US
Practice Address - Phone:605-641-0566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6955-125101YM0800X, 101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
14070741OtherCAQH
WI6955-125OtherWISCONSIN REG AND LIC
1598404816OtherNPPES