Provider Demographics
NPI:1386084424
Name:TEWELL, JESSICA CHASTAIN (MSW, MDIV, LCSW)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:CHASTAIN
Last Name:TEWELL
Suffix:
Gender:F
Credentials:MSW, MDIV, LCSW
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:LYNNE
Other - Last Name:CHASTAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23 CALEDONIA DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-1797
Mailing Address - Country:US
Mailing Address - Phone:828-361-7901
Mailing Address - Fax:828-837-5309
Practice Address - Street 1:901 TIGER CONNECTOR
Practice Address - Street 2:
Practice Address - City:TIGER
Practice Address - State:GA
Practice Address - Zip Code:30576-2301
Practice Address - Country:US
Practice Address - Phone:706-782-0459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040171591041C0700X
NCC0096471041C0700X
GACSW0094971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACSW009497OtherGA BOARD OF COUNSELORS, SOCIAL WORKERS, AND MARRIAGE AND FAMILY THERAPISTS
VA0904017159OtherVIRGINIA BOARD OF SOCIAL WORKERS
NCC009647OtherNORTH CAROLINA BOARD OF SOCIAL WORK LICENSURE AND CERTIFICATION