Provider Demographics
NPI:1316452139
Name:HALLING, JESSICA KAY (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:KAY
Last Name:HALLING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9850 S MARYLAND PKWY STE A5
Mailing Address - Street 2:#380
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-7148
Mailing Address - Country:US
Mailing Address - Phone:702-569-3766
Mailing Address - Fax:
Practice Address - Street 1:2920 N GREEN VALLEY PKWY STE 312
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-0412
Practice Address - Country:US
Practice Address - Phone:702-935-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-04
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11737-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical