Provider Demographics
NPI:1588246789
Name:SLOVER MILLER, JESSICA (LCPC, LMHC)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:SLOVER MILLER
Suffix:
Gender:F
Credentials:LCPC, LMHC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:SLOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC, LMHC
Mailing Address - Street 1:4909 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:IL
Mailing Address - Zip Code:61264-5215
Mailing Address - Country:US
Mailing Address - Phone:309-265-8852
Mailing Address - Fax:
Practice Address - Street 1:4101 JOHN DEERE RD
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-9951
Practice Address - Country:US
Practice Address - Phone:309-581-2031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA106271101YM0800X
IL180013544101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health