Provider Demographics
NPI:1386476547
Name:WATCHORN, JESSICA LYNN (PLMHP, PCMSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:WATCHORN
Suffix:
Gender:F
Credentials:PLMHP, PCMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1159 N BEECH ST
Mailing Address - Street 2:
Mailing Address - City:WAHOO
Mailing Address - State:NE
Mailing Address - Zip Code:68066-1326
Mailing Address - Country:US
Mailing Address - Phone:402-669-2043
Mailing Address - Fax:
Practice Address - Street 1:152 E 6TH ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-5092
Practice Address - Country:US
Practice Address - Phone:402-720-1742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE80621041C0700X
NE140201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical