Provider Demographics
NPI:1851055073
Name:BURGER, JESSICA (PLMHP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:BURGER
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 S 177TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2613
Mailing Address - Country:US
Mailing Address - Phone:402-669-0230
Mailing Address - Fax:
Practice Address - Street 1:1729 S 177TH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2613
Practice Address - Country:US
Practice Address - Phone:402-669-0230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12802101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health