Provider Demographics
NPI:1124251152
Name:WHITNEY, JESSICA SEAGLE (LCMHC)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:SEAGLE
Last Name:WHITNEY
Suffix:
Gender:
Credentials:LCMHC
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:MARGUERITE
Other - Last Name:SEAGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 DARTMOUTH DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NH
Mailing Address - Zip Code:03032-3982
Mailing Address - Country:US
Mailing Address - Phone:603-237-1812
Mailing Address - Fax:
Practice Address - Street 1:15 DARTMOUTH DR UNIT 102
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NH
Practice Address - Zip Code:03032-3982
Practice Address - Country:US
Practice Address - Phone:603-237-1812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1032101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3099160Medicaid