Provider Demographics
NPI:1255160990
Name:MINMIER, JESSICA ALEECE (LMSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ALEECE
Last Name:MINMIER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ALEECE
Other - Last Name:MCCLENNEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:150 COUNTRY VISTA CIR
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-7876
Mailing Address - Country:US
Mailing Address - Phone:405-819-5681
Mailing Address - Fax:
Practice Address - Street 1:150 COUNTRY VISTA CIR
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7876
Practice Address - Country:US
Practice Address - Phone:405-819-5681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106090104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker