Provider Demographics
NPI:1003536681
Name:WARPUP, JESSICA RENEE-YI (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:RENEE-YI
Last Name:WARPUP
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1696 FOREST RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-4795
Mailing Address - Country:US
Mailing Address - Phone:231-620-6017
Mailing Address - Fax:
Practice Address - Street 1:735 S. GARFIFELD AVE.
Practice Address - Street 2:SUITE 200
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-3471
Practice Address - Country:US
Practice Address - Phone:231-620-6017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801112376104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker