Provider Demographics
NPI:1124351648
Name:FLORANG, JESSE EDWARD (LMHP)
Entity type:Individual
Prefix:MR
First Name:JESSE
Middle Name:EDWARD
Last Name:FLORANG
Suffix:
Gender:M
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6812 M AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-1547
Mailing Address - Country:US
Mailing Address - Phone:402-616-9842
Mailing Address - Fax:
Practice Address - Street 1:6812 M AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-1547
Practice Address - Country:US
Practice Address - Phone:402-616-9842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3924101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health