Provider Demographics
NPI:1215449756
Name:MCBRIDE PAUNA, JESSICA C (LPCC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:C
Last Name:MCBRIDE PAUNA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 JAMESON ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-1447
Mailing Address - Country:US
Mailing Address - Phone:612-867-6691
Mailing Address - Fax:
Practice Address - Street 1:2356 UNIVERSITY AVE W STE 210
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1800
Practice Address - Country:US
Practice Address - Phone:651-242-5548
Practice Address - Fax:651-242-5548
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01586101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health