Provider Demographics
NPI:1013187871
Name:LOWE, JESSICA I (LIMHP, LICSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:I
Last Name:LOWE
Suffix:
Gender:F
Credentials:LIMHP, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6028 S 102ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-4565
Mailing Address - Country:US
Mailing Address - Phone:402-510-4409
Mailing Address - Fax:
Practice Address - Street 1:6028 S 102ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-4565
Practice Address - Country:US
Practice Address - Phone:402-510-4409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE65451041C0700X
NE14301041C0700X
IA1015161041C0700X
NE2729101YM0800X
NE8206101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical