Provider Demographics
NPI:1700451432
Name:MICHAELS, JESSICA K (MA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:K
Last Name:MICHAELS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 WILSON CT APT 105
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18067-8233
Mailing Address - Country:US
Mailing Address - Phone:484-550-0181
Mailing Address - Fax:
Practice Address - Street 1:1101 NORTHAMPTON ST STE 201
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-4152
Practice Address - Country:US
Practice Address - Phone:484-540-0278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor