Provider Demographics
NPI:1962129452
Name:LINSCOTT, JESSICA RENEE
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RENEE
Last Name:LINSCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 331
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03821-0331
Mailing Address - Country:US
Mailing Address - Phone:978-238-0045
Mailing Address - Fax:
Practice Address - Street 1:1 WASHINGTON ST STE 2159
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3848
Practice Address - Country:US
Practice Address - Phone:978-238-0045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2535101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional