Provider Demographics
NPI:1952667990
Name:NCUBE, JESSICA F (LCSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:F
Last Name:NCUBE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2072 OAKHURST WAY
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-1829
Mailing Address - Country:US
Mailing Address - Phone:561-203-1018
Mailing Address - Fax:
Practice Address - Street 1:11911 US HIGHWAY 1
Practice Address - Street 2:STE 201-23
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-2827
Practice Address - Country:US
Practice Address - Phone:561-203-1018
Practice Address - Fax:561-622-6815
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
FLSW105981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty