Individual
MISS JESSICA SHANNON WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
1589 HILL RISE DR, LEXINGTON, KY 40504-2588
(859) 977-2525
(859) 233-9231
Mailing address
1589 HILL RISE DR, LEXINGTON, KY 40504-2588
(859) 977-2525
(859) 233-9231
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
164582
KY
101YA0400X
Addiction (Substance Use Disorder) Counselor
ADCADC00225693
KY
175T00000X
Peer Specialist
—
KY
Other
Enumeration date
05/03/2016
Last updated
03/20/2017
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