Provider Demographics
NPI:1104105196
Name:MCGLONE, JESSICA D (MED, LPCC, NCC)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:D
Last Name:MCGLONE
Suffix:
Gender:F
Credentials:MED, LPCC, NCC
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:D
Other - Last Name:BAYLESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-0550
Mailing Address - Country:US
Mailing Address - Phone:606-291-3355
Mailing Address - Fax:502-331-6062
Practice Address - Street 1:174 CHRISTY CRK
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-9658
Practice Address - Country:US
Practice Address - Phone:606-291-3355
Practice Address - Fax:502-331-6062
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY173090101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health