Individual
JESSE TALLYEN
Active
Individual
JESSE TALLYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW, LCDP, CADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CD-0010151
DE
104100000X
Social Worker
Primary
Q3-0011153
DE
1041C0700X
Clinical Social Worker
Primary
Q1-0012889
DE
Other
Enumeration date
12/08/2025
Last updated
02/27/2026
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