Provider Demographics
NPI:1417772385
Name:MUSSELMAN, JESSICA RANAE (MATS, CADAC II)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:RANAE
Last Name:MUSSELMAN
Suffix:
Gender:F
Credentials:MATS, CADAC II
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:NESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:209 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SIMS
Mailing Address - State:IN
Mailing Address - Zip Code:46986-9672
Mailing Address - Country:US
Mailing Address - Phone:765-513-0558
Mailing Address - Fax:
Practice Address - Street 1:1001 N WESTERN AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-2500
Practice Address - Country:US
Practice Address - Phone:812-200-2789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)