Provider Demographics
NPI:1780826065
Name:TOWNSEND, JESSICA RAE (MA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:RAE
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 BALLSTON AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-4723
Mailing Address - Country:US
Mailing Address - Phone:518-587-8008
Mailing Address - Fax:518-587-8241
Practice Address - Street 1:70 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:NY
Practice Address - Zip Code:12834-1211
Practice Address - Country:US
Practice Address - Phone:518-636-0483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY006700OtherNYS LIC