Provider Demographics
NPI:1609382167
Name:KLAHSEN, JESSICA LYNNE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LYNNE
Last Name:KLAHSEN
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 1:2530 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701
Mailing Address - Country:US
Mailing Address - Phone:319-229-5030
Mailing Address - Fax:319-290-2714
Practice Address - Street 1:2530 UNIVERSITY AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701
Practice Address - Country:US
Practice Address - Phone:319-229-5030
Practice Address - Fax:319-290-2714
Is Sole Proprietor?:No
Enumeration Date:2017-12-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA084319104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker