Provider Demographics
NPI:1699812826
Name:WILLEMSEN, JESSICA LYNN (MSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:WILLEMSEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 SHAWNEE MISSION PKWY
Mailing Address - Street 2:SUITE 219
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4005
Mailing Address - Country:US
Mailing Address - Phone:816-295-7223
Mailing Address - Fax:913-232-2681
Practice Address - Street 1:6901 SHAWNEE MISSION PKWY
Practice Address - Street 2:SUITE 219
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-4005
Practice Address - Country:US
Practice Address - Phone:816-295-7223
Practice Address - Fax:913-232-2681
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040242621041C0700X
KS35961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical