Jessica Conrad, LPCC
Individual provider Active NPI Professional Counselor · Lambertville, MI
NPI 1194211276 · NPPES record last updated May 18, 2023
Key facts
- NPI
- 1194211276
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- E.2303275 (OH)
- Practice address
- 6654 Brentridge LN
Lambertville, MI 48144-9374 - Phone
- (419) 410-5803
- NPI assigned
- Jul 2, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E.2303275 | OH | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| Professional Counselor | 101YP2500X | E.2303275 | OH | Yes |
Addresses
Primary practice location
6654 Brentridge LN
Lambertville, MI 48144-9374
Mailing address
6654 Brentridge LN
Lambertville, MI 48144-9374
Phone (419) 410-5803
Other practice location 1
1832 Adams St
Toledo, OH 43604-4428
Phone (419) 720-9247
Other providers in Lambertville, MI
- Kelly Nicole Chisholm
- Christian Care Connection LLC
- Citadel Health Equipment Corp.
- Andrew Leon Clark
- Tracy Collum
- Coppernova Health, LLC
- Mindy Christine Costello
- Chelsie Crawford
- John Arthur Crayne
- Benjamin Dahl
All providers in Lambertville, MI · Professional Counselor in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.