Provider Demographics
NPI:1174235097
Name:HAYMAKER-PARSONS, JESSICA (LSCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HAYMAKER-PARSONS
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 POYNTZ AVE STE 276
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-8039
Mailing Address - Country:US
Mailing Address - Phone:913-353-4062
Mailing Address - Fax:
Practice Address - Street 1:330 POYNTZ AVE STE 276
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-8039
Practice Address - Country:US
Practice Address - Phone:913-353-4062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-22
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS059811041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty