Provider Demographics
NPI:1265047625
Name:KEY, JESSICA M (MS, LPC)
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:M
Last Name:KEY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9130 83RD ST APT 133
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-2558
Mailing Address - Country:US
Mailing Address - Phone:262-327-7452
Mailing Address - Fax:
Practice Address - Street 1:9130 83RD ST APT 133
Practice Address - Street 2:
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-2558
Practice Address - Country:US
Practice Address - Phone:262-327-7452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-12
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10376101Y00000X
WI10376-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor