Basic Information
| Provider Information | |||||||||
| NPI: | 1851383905 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JESSING | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | EILEEN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LMHP, LMFT, LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2702 FONTENELLE BLVD | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681044542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025587221 | ||||||||
| FaxNumber: | 4025527444 | ||||||||
| Practice Location | |||||||||
| Address1: | 11949 Q ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681373503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4029816727 | ||||||||
| FaxNumber: | 4029322431 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2005 | ||||||||
| LastUpdateDate: | 02/09/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | LPC 66 | NE | N | Behavioral Health & Social Service Providers | Counselor | 101YM0800X | LMHP 558 | NE | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 106H00000X | LMFT 67 | NE | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
ID Information
| ID | Type | State | Issuer | Description | 470789054 26 | 05 | NE | MEDICAID |