Provider Demographics
NPI:1396209888
Name:ERMLER, JESSICA MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:ERMLER
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 1:474 HUTTON CIR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-4845
Mailing Address - Country:US
Mailing Address - Phone:515-745-3537
Mailing Address - Fax:
Practice Address - Street 1:474 HUTTON CIR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-4845
Practice Address - Country:US
Practice Address - Phone:515-745-3537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS104971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical