Provider Demographics
NPI:1720667108
Name:PIGOTT, JESSICA MAE (LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MAE
Last Name:PIGOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 1ST ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-2102
Mailing Address - Country:US
Mailing Address - Phone:517-998-4673
Mailing Address - Fax:517-998-0005
Practice Address - Street 1:207 1ST ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2102
Practice Address - Country:US
Practice Address - Phone:517-998-4673
Practice Address - Fax:517-998-0005
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017518101Y00000X
MI6401222264101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor