Provider Demographics
NPI:1710242284
Name:NORMAN, JESSICA NICOLE (PHD LCPC)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:NICOLE
Last Name:NORMAN
Suffix:
Gender:
Credentials:PHD LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24W500 MAPLE AVE STE 216
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6057
Mailing Address - Country:US
Mailing Address - Phone:630-423-6010
Mailing Address - Fax:844-270-7898
Practice Address - Street 1:24W500 MAPLE AVE STE 216
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6057
Practice Address - Country:US
Practice Address - Phone:630-423-6010
Practice Address - Fax:844-270-7898
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180010623101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional