Provider Demographics
NPI:1235681412
Name:SPEARS, JESSICA ANNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ANNE
Last Name:SPEARS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:TRIPLETT
Other - Last Name:SPEARS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:5420 VALLEY RUN ST
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-9453
Mailing Address - Country:US
Mailing Address - Phone:828-308-9957
Mailing Address - Fax:
Practice Address - Street 1:5420 VALLEY RUN ST
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-9453
Practice Address - Country:US
Practice Address - Phone:828-308-9957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-03
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0100161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical