Provider Demographics
NPI:1023773173
Name:SHINTON, JESSICA LEE (LPC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEE
Last Name:SHINTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LEE
Other - Last Name:KOVALCHICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:855 GETTYSBURG DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-3103
Mailing Address - Country:US
Mailing Address - Phone:609-954-7617
Mailing Address - Fax:
Practice Address - Street 1:855 GETTYSBURG DR
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-3103
Practice Address - Country:US
Practice Address - Phone:609-954-7617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013144101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health