Provider Demographics
NPI:1295372423
Name:SHIELDS, JESSICA (MS, EDS, LPC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SHIELDS
Suffix:
Gender:
Credentials:MS, EDS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4037 US HIGHWAY 231 STE E
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36093-1224
Mailing Address - Country:US
Mailing Address - Phone:334-315-5515
Mailing Address - Fax:
Practice Address - Street 1:4037 US HIGHWAY 231 STE E
Practice Address - Street 2:
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36093-1224
Practice Address - Country:US
Practice Address - Phone:334-315-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-06
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor