Provider Demographics
NPI:1972111532
Name:STANKO, JESSICA SANDERS (MS, LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:SANDERS
Last Name:STANKO
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 ASHBURY LN
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-1959
Mailing Address - Country:US
Mailing Address - Phone:913-908-3702
Mailing Address - Fax:
Practice Address - Street 1:17103 PRESTON RD STE 160
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1486
Practice Address - Country:US
Practice Address - Phone:469-708-6520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-20
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79407101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health