Provider Demographics
NPI:1053151217
Name:BATTLE, JESSE JR (LCMHC, LCAS, CCS, MA)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:BATTLE
Suffix:JR
Gender:M
Credentials:LCMHC, LCAS, CCS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12428 N EXETER WAY
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-8532
Mailing Address - Country:US
Mailing Address - Phone:919-730-3470
Mailing Address - Fax:
Practice Address - Street 1:12428 N EXETER WAY
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-8532
Practice Address - Country:US
Practice Address - Phone:919-730-3470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10937101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health