Provider Demographics
NPI:1811149800
Name:LARUBBIO, JESSICA L (LPCC-S, LICDC-CS)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:L
Last Name:LARUBBIO
Suffix:
Gender:F
Credentials:LPCC-S, LICDC-CS
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:L
Other - Last Name:O'DEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16761 SAINT CLAIR AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-9400
Mailing Address - Country:US
Mailing Address - Phone:330-932-1823
Mailing Address - Fax:330-932-1832
Practice Address - Street 1:16761 SAINT CLAIR AVE STE 2
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9400
Practice Address - Country:US
Practice Address - Phone:330-932-1823
Practice Address - Fax:330-932-1832
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.06000051101YA0400X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)