Provider Demographics
NPI:1962117887
Name:KURRLE, JESSICA ELIZABETH (LGPC)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ELIZABETH
Last Name:KURRLE
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 MILLDAM RD
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-1430
Mailing Address - Country:US
Mailing Address - Phone:443-413-4257
Mailing Address - Fax:
Practice Address - Street 1:57 W TIMONIUM RD STE 207
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3105
Practice Address - Country:US
Practice Address - Phone:443-729-0828
Practice Address - Fax:443-819-1321
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP13475101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health