Provider Demographics
NPI:1841774973
Name:FELTNER, JESSICA WADE (LPCA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:WADE
Last Name:FELTNER
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 WAINSCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-1970
Mailing Address - Country:US
Mailing Address - Phone:859-595-5860
Mailing Address - Fax:
Practice Address - Street 1:19 WAINSCOTT AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-1970
Practice Address - Country:US
Practice Address - Phone:859-595-5860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY243810101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional