Individual
MS. JESSICA LEA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPC NCC
Contact information
Practice address
1320 MENDOTA ST STE 120, MADISON, WI 53714-1060
(608) 280-3106
Mailing address
25 KESSEL CT STE 105, MADISON, WI 53711-6227
(608) 280-2700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
5854-125
WI
101YP2500X
Professional Counselor
LPC.0011615
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679708390
—
WI
Enumeration date
05/26/2009
Last updated
08/19/2016
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