Provider Demographics
NPI:1124562723
Name:FILIATREAU, JESSICA (LCPC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:FILIATREAU
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 18TH ST
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-0301
Mailing Address - Country:US
Mailing Address - Phone:309-520-4130
Mailing Address - Fax:
Practice Address - Street 1:2500 18TH ST
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-0301
Practice Address - Country:US
Practice Address - Phone:309-520-4130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-15
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA106439101YM0800X
IL180-010526101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILPENDINGMedicaid