Provider Demographics
NPI:1639866759
Name:ESTEP, JESSICA L (CDCA)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:L
Last Name:ESTEP
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:L
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3049 SOUTHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-3231
Mailing Address - Country:US
Mailing Address - Phone:614-506-6467
Mailing Address - Fax:
Practice Address - Street 1:3049 SOUTHFIELD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-3231
Practice Address - Country:US
Practice Address - Phone:614-506-6467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.184160101YA0400X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)