Provider Demographics
NPI:1790371797
Name:SCHNEIDER, JESSICA ANNE (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANNE
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-4432
Mailing Address - Country:US
Mailing Address - Phone:720-400-2412
Mailing Address - Fax:
Practice Address - Street 1:1007 S 12TH ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4432
Practice Address - Country:US
Practice Address - Phone:720-400-2412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO248578101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool