Individual provider Active NPI

Jessica Nicole Moody, LCPC, NCC, C.A.S.E.

  • Professional Counselor
  • Towson, MD
National Provider Identifier
1205065380
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC3100 Issued in MD
Practice address
8600 Lasalle Rd
Suite 634
Towson, MD 21286-1720
Phone
(410) 356-2007
NPI assigned
Jul 9, 2009
Last updated
Aug 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC3100 MD Primary

Addresses

Primary practice location

8600 Lasalle Rd
Suite 634
Towson, MD 21286-1720

Mailing address

8600 Lasalle Rd
Suite 634
Towson, MD 21286-1720
Phone (410) 356-2007

Other names 1

  • Jessica Nicole Cordova Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC3100MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gifts LLC CurrentSince Sep 3, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1205065380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 LASALLE RD",
            "address_2": "SUITE 634",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212861720",
            "telephone_number": "410-356-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 LASALLE RD",
            "address_2": "SUITE 634",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212861720",
            "telephone_number": "410-356-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "LCPC, NCC, C.A.S.E.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-09",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC3100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "CORDOVA",
            "middle_name": "NICOLE",
            "credential": "LCPC, NCC, C.A.S.E.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.