Cornwell, Jessica Ann
Cornwell, Jessica Ann is an sole proprietor health care provider with primary practice located at 113 Comanche Rd , Fort Meade SD 57741-1002. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Cornwell, Jessica Ann can be contacted via phone (218) 343-7584.Contact Information
Primary practice address
113 Comanche Rd
Fort Meade SD 57741-1002
Phone: (218) 343-7584
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 8627-123 | Wisconsin |
Profile Details
| NPI number | 1720658420 |
|---|---|
| LBN Legal business name | Cornwell, Jessica Ann |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 25th, 2021 |
| Last updated | Mar 20th, 2024 - about 6 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720658420 | NPPES |
| South Dakota | Other | 460429218 | BLACK HILLS HEALTH CARE CENTER |
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