Provider Demographics
NPI:1669043105
Name:GLOVER, JESSICA (LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:GLOVER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 PARK MEADOW RD STE H
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2876
Mailing Address - Country:US
Mailing Address - Phone:614-948-3273
Mailing Address - Fax:855-740-2025
Practice Address - Street 1:6465 REFLECTIONS DR STE 110
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-2353
Practice Address - Country:US
Practice Address - Phone:614-948-3273
Practice Address - Fax:855-740-2025
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
OHC.2304949101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician