Provider Demographics
NPI:1952852840
Name:FRICKE, JESSICA (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:FRICKE
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3051 MILAN ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-5836
Mailing Address - Country:US
Mailing Address - Phone:717-598-7372
Mailing Address - Fax:484-229-9189
Practice Address - Street 1:3051 MILAN ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-5836
Practice Address - Country:US
Practice Address - Phone:484-259-7809
Practice Address - Fax:484-229-9189
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0023701OtherAGENCY MEDICAID
NJ8363102OtherAGENCY MEDICAID