Provider Demographics
NPI:1528773801
Name:DILLON, JESSICA (PLMHP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:DILLON
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:LINDAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3182 FOWLER AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-2322
Mailing Address - Country:US
Mailing Address - Phone:318-331-4102
Mailing Address - Fax:
Practice Address - Street 1:3223 N 45TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-3711
Practice Address - Country:US
Practice Address - Phone:402-916-9421
Practice Address - Fax:402-999-8221
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-20
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13277101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health