Provider Demographics
NPI:1831812106
Name:DODSON, JESSICA LYN
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYN
Last Name:DODSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LYN
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, NCC, LPC
Mailing Address - Street 1:16 2ND ST
Mailing Address - Street 2:
Mailing Address - City:TAYLORSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15365-1003
Mailing Address - Country:US
Mailing Address - Phone:724-986-1626
Mailing Address - Fax:
Practice Address - Street 1:2606 NATIONAL RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-5370
Practice Address - Country:US
Practice Address - Phone:724-986-1626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1371534101YP2500X
WV3071101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional