Provider Demographics
NPI:1003154634
Name:WHITTINGTON, JESSICA ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ELIZABETH
Last Name:WHITTINGTON
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 1:213 LYNDEN LN
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-8556
Mailing Address - Country:US
Mailing Address - Phone:209-445-4369
Mailing Address - Fax:
Practice Address - Street 1:3402 TRENT RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2232
Practice Address - Country:US
Practice Address - Phone:209-445-4369
Practice Address - Fax:252-634-9332
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW94934101YM0800X
NCCO14896101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health