Provider Demographics
NPI:1871716977
Name:TERRELL, JESSICA (MS, LCPC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:TERRELL
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 S RIVER ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-5185
Mailing Address - Country:US
Mailing Address - Phone:630-844-2662
Mailing Address - Fax:
Practice Address - Street 1:84 TEMPLETON DR STE 103
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-7015
Practice Address - Country:US
Practice Address - Phone:630-844-2662
Practice Address - Fax:630-844-3084
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180016937101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional