Provider Demographics
NPI:1982271748
Name:KOWALSKI, JESSICA (MA, LLPC)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20825 GASLIGHT DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-2313
Mailing Address - Country:US
Mailing Address - Phone:989-965-5105
Mailing Address - Fax:
Practice Address - Street 1:38271 MOUND RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-3401
Practice Address - Country:US
Practice Address - Phone:586-978-0243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401019068101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health