Provider Demographics
NPI:1740668466
Name:BEMER, JESSICA (LLMSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BEMER
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:CEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW
Mailing Address - Street 1:809 S GRINNELL ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-1623
Mailing Address - Country:US
Mailing Address - Phone:517-914-1664
Mailing Address - Fax:
Practice Address - Street 1:1200 N WEST AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-2179
Practice Address - Country:US
Practice Address - Phone:517-789-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010966731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical