Jessica Lynn Duckworth, LMSW
Individual provider Active NPI Mental Health Counselor · Klondike, TX
NPI 1013540970 · NPPES record last updated Feb 19, 2020
Key facts
- NPI
- 1013540970
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 259 County Road 2020
Klondike, TX 75448-6409 - Phone
- (903) 461-2395
- NPI assigned
- Feb 19, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
259 County Road 2020
Klondike, TX 75448-6409
Mailing address
259 County Road 2020
Klondike, TX 75448-6409
Phone (903) 461-2395
Other providers in Klondike, TX
All providers in Klondike, TX · Mental Health Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.