Active NPI
Jessica Lynn Watchorn, PLMHP, PCMSW
- Clinical Social Worker
- Fremont, NE
National Provider Identifier
1386476547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 14020
- Practice address
- 152 E 6TH St
Fremont, NE 68025-5092 - Phone
- (402) 720-1742
- NPI assigned
- Aug 16, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8062 | NE | |
| Clinical Social Worker | 1041C0700X | 14020 | NE | Primary |
Addresses
Primary practice location
152 E 6TH St
Fremont, NE 68025-5092
Mailing address
1159 N Beech St
Wahoo, NE 68066-1326
Phone (402) 669-2043
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14020 | NE | MD | Clinical Social Worker |
| 8062 | NE | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lotus Behavioral Health, LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723766400000",
"number": "1386476547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1159 N BEECH ST",
"city": "WAHOO",
"state": "NE",
"postal_code": "680661326",
"telephone_number": "402-669-2043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 E 6TH ST",
"city": "FREMONT",
"state": "NE",
"postal_code": "680255092",
"telephone_number": "402-720-1742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATCHORN",
"first_name": "JESSICA",
"middle_name": "LYNN",
"credential": "PLMHP, PCMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-16",
"last_updated": "2024-08-16",
"certification_date": "2024-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NE",
"license": "8062",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NE",
"license": "14020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.