Jessica Squires Carlyle, LCMHCA
Counselor, Mental Health in Greenville, NC. Individual provider (NPI-1).
NPI number1801636618
StatusActive
Last updated in NPPESJun 26, 2024
Details
- NPI
- 1801636618
- Entity type
- Individual (NPI-1)
- Name
- Jessica Squires Carlyle
- Credential
- LCMHCA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 29, 2024
- Certification date
- Jun 26, 2024
- Last updated
- Jun 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | A20041 | NC | Yes |
Practice location
313 Clifton StGreenville, NC 27858-5008
Phone 252-353-0100
Mailing address
2206 Kathleen DrGreenville, NC 27858-9578
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