Provider Demographics
NPI:1629867668
Name:ALLEN, JESSICA LYNN (CDCA, CPRS, BHT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:CDCA, CPRS, BHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 HARDING VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-6964
Mailing Address - Country:US
Mailing Address - Phone:740-901-3046
Mailing Address - Fax:
Practice Address - Street 1:333 E CENTER ST STE 301
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-4142
Practice Address - Country:US
Practice Address - Phone:740-901-3046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No175T00000XOther Service ProvidersPeer Specialist