Provider Demographics
NPI:1447844527
Name:CARLINGTON, JESSICA RENEE (LPCA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RENEE
Last Name:CARLINGTON
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1589 HIGHWAY 15 S STE 270
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:KY
Mailing Address - Zip Code:41339-9634
Mailing Address - Country:US
Mailing Address - Phone:606-666-4668
Mailing Address - Fax:606-666-4670
Practice Address - Street 1:1589 HIGHWAY 15 S STE 270
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:KY
Practice Address - Zip Code:41339-9634
Practice Address - Country:US
Practice Address - Phone:606-666-4668
Practice Address - Fax:606-666-4670
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY246278101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYUNKNOWNMedicaid