Provider Demographics
NPI:1639216187
Name:MCCASLIN, JESSICA R (LIMHP, LMHP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:R
Last Name:MCCASLIN
Suffix:
Gender:F
Credentials:LIMHP, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 S 10TH AVE STE 101
Mailing Address - Street 2:PO BOX 204
Mailing Address - City:BROKEN BOW
Mailing Address - State:NE
Mailing Address - Zip Code:68822-2018
Mailing Address - Country:US
Mailing Address - Phone:308-381-7487
Mailing Address - Fax:
Practice Address - Street 1:255 S 10TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:BROKEN BOW
Practice Address - State:NE
Practice Address - Zip Code:68822-2018
Practice Address - Country:US
Practice Address - Phone:308-381-7487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3397101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE98431OtherBCBS
NE600014201OtherMAGELLAN HEALTH SERVICES
NE10025452100Medicaid