Soukup, Jessica L
Soukup, Jessica L is an individual health care provider with primary practice located at 407 N Walsh St , Carson City NV 89701-4268. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Soukup, Jessica L can be contacted via phone (775) 720-8676.Contact Information
Primary practice address
407 N Walsh St
Carson City NV 89701-4268
Phone: (775) 720-8676
Fax: (775) 418-7636
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 4690-C | Nevada |
Profile Details
| NPI number | 1326270042 |
|---|---|
| LBN Legal business name | Soukup, Jessica L |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 13th, 2009 |
| Last updated | Dec 2nd, 2022 - about 3 years 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 | 1326270042 | NPPES |
| Nevada | Other | 4960-C | STATE LICENSE |
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