Provider Demographics
NPI:1104626845
Name:MICHELS, JESSICA (MFT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MICHELS
Suffix:
Gender:
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 MONUMENT RD APT 506
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1765
Mailing Address - Country:US
Mailing Address - Phone:215-260-6883
Mailing Address - Fax:
Practice Address - Street 1:130 MONUMENT RD APT 506
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1765
Practice Address - Country:US
Practice Address - Phone:215-260-6883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist