Provider Demographics
NPI:1669665725
Name:SLOAN, JESSICA GWEN (MA, NCC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:GWEN
Last Name:SLOAN
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 TWIN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-3283
Mailing Address - Country:US
Mailing Address - Phone:910-270-1726
Mailing Address - Fax:
Practice Address - Street 1:962 S FAYETTEVILLE ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-6410
Practice Address - Country:US
Practice Address - Phone:336-626-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4218101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health