Provider Demographics
NPI:1316070352
Name:FLANERY, JESSICA LYNN FARMER (MS, EDS, LPC)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LYNN FARMER
Last Name:FLANERY
Suffix:
Gender:F
Credentials:MS, EDS, LPC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:FARMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, EDS, LPC
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-277-6050
Mailing Address - Fax:336-992-3141
Practice Address - Street 1:280 BROAD ST
Practice Address - Street 2:SUITE E
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-2796
Practice Address - Country:US
Practice Address - Phone:336-277-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6462101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional