| Jessica Horness Llc | |
|
830 E Front St Traverse City MI 49686-2528 | |
| (989) 600-0929 | |
| Not Available |
| Full Name | Jessica Horness Llc |
|---|---|
| Speciality | Counselor |
| Location | 830 E Front St, Traverse City, Michigan |
| Authorized Official Name and Position | Jessica Horness (OWNER) |
| Authorized Official Contact | 9896000929 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Horness Llc 830 E Front St Traverse City MI 49686-2528 Ph: () - | Jessica Horness Llc 830 E Front St Traverse City MI 49686-2528 Ph: (989) 600-0929 |
| NPI Number | 1790494722 |
|---|---|
| Provider Enumeration Date | 11/17/2022 |
| Last Update Date | 10/03/2023 |
| Certification Date | 10/02/2023 |
| Medicare PECOS PAC ID | 8224488622 |
|---|---|
| Medicare Enrollment ID | O20231227002787 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790494722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jessica Ruth Horness |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851924591 PECOS PAC ID: 9133579535 Enrollment ID: I20231227002829 |
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