Provider Demographics
NPI:1891228219
Name:TAPPANA, JESSICA (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:TAPPANA
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 BARNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-3893
Mailing Address - Country:US
Mailing Address - Phone:573-328-2288
Mailing Address - Fax:
Practice Address - Street 1:2012 CHERRY HILL DR
Practice Address - Street 2:STE 202 OFFICE B
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-5882
Practice Address - Country:US
Practice Address - Phone:573-328-2288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20150057801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical