Provider Demographics
NPI:1861647406
Name:MCLEOD, JESSICA (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:MRS
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:2506 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-2930
Mailing Address - Country:US
Mailing Address - Phone:870-230-8217
Mailing Address - Fax:870-230-8201
Practice Address - Street 1:2506 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71923-2930
Practice Address - Country:US
Practice Address - Phone:870-230-8217
Practice Address - Fax:870-230-8201
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP9811033101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional