Provider Demographics
NPI:1124265145
Name:VINES-RITCHEY, JESSICA ANN (LPC, CRC)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:ANN
Last Name:VINES-RITCHEY
Suffix:
Gender:F
Credentials:LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13121 LOUETTA RD
Mailing Address - Street 2:PMB 915
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429
Mailing Address - Country:US
Mailing Address - Phone:281-857-6733
Mailing Address - Fax:281-251-0705
Practice Address - Street 1:111 HOUSTON ST
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4759
Practice Address - Country:US
Practice Address - Phone:281-255-9922
Practice Address - Fax:281-255-9922
Is Sole Proprietor?:No
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19129101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health