Provider Demographics
NPI:1841653888
Name:DENNEY, JESSICA D (LPCC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:D
Last Name:DENNEY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1088 WASSERMAN WAY
Mailing Address - Street 2:SUITE C
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-1974
Mailing Address - Country:US
Mailing Address - Phone:513-735-8129
Mailing Address - Fax:513-735-8103
Practice Address - Street 1:1088 WASSERMAN WAY
Practice Address - Street 2:SUITE C
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-1974
Practice Address - Country:US
Practice Address - Phone:513-735-8129
Practice Address - Fax:513-735-8103
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1901201101YP2500X
OH011288101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0350672Medicaid