Provider Demographics
NPI:1386084424
Name:TEWELL, JESSICA CHASTAIN (MSW, MDIV, LCSW)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:CHASTAIN
Last Name:TEWELL
Suffix:
Gender:F
Credentials:MSW, MDIV, LCSW
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:LYNNE
Other - Last Name:CHASTAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23 CALEDONIA DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-1797
Mailing Address - Country:US
Mailing Address - Phone:828-361-7901
Mailing Address - Fax:828-837-5309
Practice Address - Street 1:23 CALEDONIA DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-1797
Practice Address - Country:US
Practice Address - Phone:828-361-7901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0096471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical