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Jessica Brake, Lpc, Llc
Professional Counselor in Roseburg, Oregon
NPI 1578287090

Jessica Brake, Lpc, Llc is a Professional Counselor based in Roseburg, OR and is specialized in Professional. Jessica Brake, Lpc, Llc practices in Roseburg, OR. The NPI Number for Jessica Brake, Lpc, Llc is 1578287090 and holds a License No. (Oregon).

The current practice location address for Jessica Brake, Lpc, Llc is 2233 W Harvard Ave, Roseburg, OR and can be reached out via phone at 541-704-8745.

Location: 2233 W Harvard Ave, Roseburg, OR, 97470-0420
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1578287090
Provider Name
Jessica Brake, Lpc, Llc
Credential
Provider Entity Type
Organization
Address
2233 W Harvard Ave, Roseburg, OR, 97470-0420
Phone Number
541-704-8745
Fax Number
Provider Enumeration Date
09/28/2022
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500663462 05 OR
institution
Provider Business Practice Location Address Details
Address
2233 W Harvard Ave
City
Roseburg
State
Oregon
Zip
97471-2550
Phone Number
541-704-8745
Fax Number
person
Provider Business Mailing Address Details
Address
2233 W Harvard Ave
City
Roseburg
State
Oregon
Zip
97471-2550
Phone Number
541-704-8745
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
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Definition
Definition to come...
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