Provider Demographics
NPI:1184194664
Name:GRUBER, JESSICA MARIE (PHD, LCASA)
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:MARIE
Last Name:GRUBER
Suffix:
Gender:F
Credentials:PHD, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3770 SKYLAND DR
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-8360
Mailing Address - Country:US
Mailing Address - Phone:828-399-1399
Mailing Address - Fax:828-475-0400
Practice Address - Street 1:3770 SKYLAND DR
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-8360
Practice Address - Country:US
Practice Address - Phone:828-399-1399
Practice Address - Fax:828-475-0400
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24589101YA0400X
NC5624103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)