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:
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Health care specialties

SpecialtyCodeLicense #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 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326270042 NPPES
Nevada Other 4960-C STATE LICENSE

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