Individual
JESSICA M VANDERCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHP
Contact information
Practice address
5605 NORTHERN HILLS DR, OMAHA, NE 68152-1192
(402) 980-1261
(402) 980-1261
Mailing address
5605 NORTHERN HILLS DR, OMAHA, NE 68152-1192
(402) 980-1261
(402) 980-1261
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3948
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588006993
—
NE
Enumeration date
07/26/2013
Last updated
03/02/2020
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