Provider Demographics
NPI:1467145540
Name:JESSICA ROBB, LMSW, PLLC
Entity Type:Organization
Organization Name:JESSICA ROBB, LMSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROBB
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CAADC, CCS
Authorized Official - Phone:269-366-8006
Mailing Address - Street 1:7311 SANDPIPER ST
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-7404
Mailing Address - Country:US
Mailing Address - Phone:269-366-8006
Mailing Address - Fax:
Practice Address - Street 1:2001 HUDSON AVE STE D
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-1889
Practice Address - Country:US
Practice Address - Phone:269-371-5970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty