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Individual
JESSICA G. TATE
Active
Individual
JESSICA G. TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRC, LCAS, LPC, MAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2062
NC
101YP2500X
Professional Counselor
10900
NC
101YP2500X
Professional Counselor
168173
KY
Other
Enumeration date
11/04/2011
Last updated
06/30/2016
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