Jessica Anderson, LPC-ASSOCIATE
Individual provider Active NPI Counselor · Longview, TX
NPI 1720848310 · NPPES record last updated Mar 20, 2024
Key facts
- NPI
- 1720848310
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 94672 (TX)
- Practice address
- 2814 Bill Owens Pkwy Ste 200
Longview, TX 75605-2103 - Phone
- (903) 261-9392
- NPI assigned
- Mar 20, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| 94672 | TX | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jessica Anderson PLLC | Single Specialty | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | 94672 | TX | Yes |
Addresses
Primary practice location
2814 Bill Owens Pkwy Ste 200
Longview, TX 75605-2103
Mailing address
2402 Shadow CRK
Longview, TX 75605-2563
Phone (903) 261-9392
Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2024. 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.