Provider Demographics
NPI:1689978546
Name:PLATT, JESSICA LYNN (PCC-S)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LYNN
Last Name:PLATT
Suffix:
Gender:F
Credentials:PCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:873 E PARKHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-3913
Mailing Address - Country:US
Mailing Address - Phone:440-241-1043
Mailing Address - Fax:
Practice Address - Street 1:10427 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-1645
Practice Address - Country:US
Practice Address - Phone:216-521-6511
Practice Address - Fax:216-521-6006
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE. 0500536-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional