Provider Demographics
NPI:1447268867
Name:BURKHAMER, JESSICA T (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:T
Last Name:BURKHAMER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:T
Other - Last Name:BURKHAMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW,LCSW
Mailing Address - Street 1:615 SIERRA ROSE DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2060
Mailing Address - Country:US
Mailing Address - Phone:775-826-1002
Mailing Address - Fax:775-826-7575
Practice Address - Street 1:615 SIERRA ROSE DR
Practice Address - Street 2:SUITE 4
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2060
Practice Address - Country:US
Practice Address - Phone:775-826-1002
Practice Address - Fax:775-826-7575
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01803-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical