Provider Demographics
NPI:1821780594
Name:SZMANDA, JESSICA A (LPCC, LADC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:SZMANDA
Suffix:
Gender:F
Credentials:LPCC, LADC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:WESTLUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:315 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MN
Mailing Address - Zip Code:55092-9748
Mailing Address - Country:US
Mailing Address - Phone:612-234-2605
Mailing Address - Fax:
Practice Address - Street 1:145 KING RD
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MN
Practice Address - Zip Code:55092-9711
Practice Address - Country:US
Practice Address - Phone:612-201-2591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN305777101YA0400X
MNCC04415101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)