Jessica Triplett
Individual provider Active NPI Professional Counselor · Coal Grove, OH
NPI 1962774307 · NPPES record last updated Mar 2, 2021
Key facts
- NPI
- 1962774307
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- E.1000343-SUPV (OH)
- Practice address
- 225 Carlton Davidson Lane
Coal Grove, OH 45638 - Phone
- (740) 533-0648
- NPI assigned
- Feb 1, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| C.1000343 | OH | MD | Mental Health Counselor |
| E.1000343-SUPV | OH | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohio Mindful Psychotherapy Services LLC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C.1000343 | OH | |
| Professional Counselor | 101YP2500X | E.1000343-SUPV | OH | Yes |
Addresses
Primary practice location
225 Carlton Davidson Lane
Coal Grove, OH 45638
Mailing address
225 Carlton Davidson LN
Coal Grove, OH 45638-2924
Phone (740) 354-7702
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08258 | Medicaid | OH |
Other providers in Coal Grove, OH
- Kelly Stickler
- Christopher A Surber
- Fredrick Jason Tackett
- Julia Taylor
- Shannon Tomblin
- Justin Triplett
- Peter Tsai
- Tahsiung Tsai
- United Family Recovery, LLC
- United Family Recovery, LLC
All providers in Coal Grove, OH · Professional Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2021. 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.