Provider Demographics
NPI:1396528618
Name:BETTEN, JESSICA JANE (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:JANE
Last Name:BETTEN
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 1:532 101ST AVE N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-3201
Mailing Address - Country:US
Mailing Address - Phone:239-645-9454
Mailing Address - Fax:
Practice Address - Street 1:2345 STANFORD CT STE 602
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-4841
Practice Address - Country:US
Practice Address - Phone:239-880-2074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW245501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty