Provider Demographics
NPI:1285320846
Name:JERNIGAN, ESSENCE P (MSW, CSW-I)
Entity type:Individual
Prefix:MRS
First Name:ESSENCE
Middle Name:P
Last Name:JERNIGAN
Suffix:
Gender:F
Credentials:MSW, CSW-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5244 ISLAND CHAIN RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1361
Mailing Address - Country:US
Mailing Address - Phone:310-367-2910
Mailing Address - Fax:
Practice Address - Street 1:5576 S FORT APACHE RD STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-3607
Practice Address - Country:US
Practice Address - Phone:702-582-7480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical