Provider Demographics
NPI:1952856635
Name:ILUNGA, JESSICA PAGE (LMHC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:PAGE
Last Name:ILUNGA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:PAGE
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:5842 MAIN ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5710
Mailing Address - Country:US
Mailing Address - Phone:716-464-2737
Mailing Address - Fax:
Practice Address - Street 1:5842 MAIN ST STE 2B
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5710
Practice Address - Country:US
Practice Address - Phone:716-464-2737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007705101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health