Provider Demographics
NPI:1811483282
Name:HOGUE, JESSAMYN LOOMIS (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:JESSAMYN
Middle Name:LOOMIS
Last Name:HOGUE
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:MS
Other - First Name:JESSAMYN
Other - Middle Name:MARY
Other - Last Name:LOOMIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2429 REGENCY DR
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-3025
Mailing Address - Country:US
Mailing Address - Phone:228-365-2986
Mailing Address - Fax:
Practice Address - Street 1:2429 REGENCY DR
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-3025
Practice Address - Country:US
Practice Address - Phone:228-365-2986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2273101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional