Provider Demographics
NPI:1669360400
Name:HUGHLEY, JESSICA DANIELLE (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:DANIELLE
Last Name:HUGHLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:DANIELLE
Other - Last Name:JETER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:212 LIZ LN
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-5003
Mailing Address - Country:US
Mailing Address - Phone:254-548-5851
Mailing Address - Fax:254-548-5851
Practice Address - Street 1:212 LIZ LN
Practice Address - Street 2:
Practice Address - City:HARVEST
Practice Address - State:AL
Practice Address - Zip Code:35749-5003
Practice Address - Country:US
Practice Address - Phone:254-548-5851
Practice Address - Fax:254-548-5851
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6252C1041C0700X
SC179951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical