Provider Demographics
NPI:1053543108
Name:GLOVER, JESSICA LYNN (MA, LMHC)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LYNN
Last Name:GLOVER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2400 NE 95TH ST
Mailing Address - Street 2:RYTHER
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2426
Mailing Address - Country:US
Mailing Address - Phone:206-525-5050
Mailing Address - Fax:206-525-9795
Practice Address - Street 1:2400 NE 95TH ST
Practice Address - Street 2:RYTHER
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2426
Practice Address - Country:US
Practice Address - Phone:206-525-5050
Practice Address - Fax:206-525-9795
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60296133101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor