Individual
MRS. JESSICA LYNN SHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC, ATR-BC, RYT
Contact information
Practice address
794 AVENIDA CODORNIZ, SAN MARCOS, CA 92069-7354
(847) 877-8494
Mailing address
794 AVENIDA CODORNIZ, SAN MARCOS, CA 92069-7354
(847) 877-8494
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
180.007403
IL
101YP2500X
Professional Counselor
Primary
1141
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XOF845726994
BLUE CROSS BLLUE SHIELD
IL
Enumeration date
10/16/2007
Last updated
01/28/2021
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