Provider Demographics
NPI:1013516517
Name:KURPIEL, JESSICA ANN (LSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:KURPIEL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9247 BROADWAY STE BB
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7008
Mailing Address - Country:US
Mailing Address - Phone:219-323-3311
Mailing Address - Fax:
Practice Address - Street 1:244 N CRAIG PL
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-2007
Practice Address - Country:US
Practice Address - Phone:708-712-8447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150014264104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker