Provider Demographics
NPI:1235665886
Name:KEASLING, JORDYN LEA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JORDYN
Middle Name:LEA
Last Name:KEASLING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JORDYN
Other - Middle Name:LEA
Other - Last Name:PFEIFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:835 S BURLINGTON AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-6928
Mailing Address - Country:US
Mailing Address - Phone:402-463-7711
Mailing Address - Fax:402-460-5829
Practice Address - Street 1:835 S BURLINGTON AVE STE 108
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-6928
Practice Address - Country:US
Practice Address - Phone:402-463-7711
Practice Address - Fax:402-460-5829
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2756104100000X
NE71031041C0700X
NE11016101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical