Provider Demographics
NPI:1255733689
Name:JACOBS, JESSICA VAN NESS (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:VAN NESS
Last Name:JACOBS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:MORGAN
Other - Last Name:VAN NESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:313 WESTERN BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-9217
Mailing Address - Country:US
Mailing Address - Phone:317-426-1847
Mailing Address - Fax:
Practice Address - Street 1:313 WESTERN BLVD STE E
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-9217
Practice Address - Country:US
Practice Address - Phone:317-426-1847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34008517A1041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical