Provider Demographics
NPI:1609264035
Name:HERRING, JESSICA KAE (NCC, LPCC, LCADC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:KAE
Last Name:HERRING
Suffix:
Gender:F
Credentials:NCC, LPCC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 WALLER AVE STE 220 AND 200
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2900
Mailing Address - Country:US
Mailing Address - Phone:859-309-2384
Mailing Address - Fax:859-406-1066
Practice Address - Street 1:389 WALLER AVE STE 220 AND 200
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2900
Practice Address - Country:US
Practice Address - Phone:859-309-2384
Practice Address - Fax:859-406-1066
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY101YA0400X
KY245535101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)