Individual
JESSICA JOYCE QUEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
610 1/2, SUITE F, POINT PLEASANT, WV 25550-1121
(304) 812-5426
(304) 812-5427
Mailing address
8674 BLACK OAK RD, FRAZIERS BOTTOM, WV 25082-8009
(304) 812-6966
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
—
WV
1041C0700X
Clinical Social Worker
Primary
BP00945935
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP00945935
WV BOARD OF SOCIAL WORK
WV
Enumeration date
09/16/2020
Last updated
01/17/2025
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