Provider Demographics
NPI:1023636719
Name:SUBLETT, JESSICA R (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:R
Last Name:SUBLETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 CHARLES DR
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1670
Mailing Address - Country:US
Mailing Address - Phone:484-213-6144
Mailing Address - Fax:
Practice Address - Street 1:2784 EGYPT RD
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:PA
Practice Address - Zip Code:19403-2255
Practice Address - Country:US
Practice Address - Phone:610-850-8009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-08
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health