Provider Demographics
NPI:1174757454
Name:LESSARD, JAYNE ISAACSON (MA CLINICAL PSY)
Entity type:Individual
Prefix:MRS
First Name:JAYNE
Middle Name:ISAACSON
Last Name:LESSARD
Suffix:
Gender:F
Credentials:MA CLINICAL PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 GEORGETOWN CT
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7448
Mailing Address - Country:US
Mailing Address - Phone:336-988-6433
Mailing Address - Fax:
Practice Address - Street 1:1317 GEORGETOWN CT
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7448
Practice Address - Country:US
Practice Address - Phone:336-988-6433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2016-02-05
Deactivation Date:2012-10-01
Deactivation Code:
Reactivation Date:2016-02-05
Provider Licenses
StateLicense IDTaxonomies
NC2191101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional