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Organization
JESSICA MIX MFT, INC.
Active
Organization
JESSICA MIX MFT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA MIX-TESMER MFT (OWNER)
(702) 673-7796
Entity
Organization
Contact information
Practice address
5785 CENTENNIAL CENTER BLVD STE 240, LAS VEGAS, NV 89149-7108
(702) 673-7796
(866) 611-8528
Mailing address
8414 FARM RD STE 180, LAS VEGAS, NV 89131-8007
(702) 673-7796
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205149044
INDIVIDUAL NPI
NV
01
—
1215558143
GROUP NPI
NV
Enumeration date
05/01/2020
Last updated
06/20/2024
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