Provider Demographics
NPI:1881733343
Name:WEST, JESSICA GIDEON (LPC)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:GIDEON
Last Name:WEST
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27 WINTER WHEAT PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-4351
Mailing Address - Country:US
Mailing Address - Phone:832-725-6646
Mailing Address - Fax:281-292-4018
Practice Address - Street 1:1600 LAKE FRONT CIR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3613
Practice Address - Country:US
Practice Address - Phone:832-725-6646
Practice Address - Fax:281-292-4018
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17454101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional