Provider Demographics
NPI:1366886764
Name:MARKS, JESSICA NICOLE (MFT)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:NICOLE
Last Name:MARKS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 EDGEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SPRING CREEK
Mailing Address - State:NV
Mailing Address - Zip Code:89815-5709
Mailing Address - Country:US
Mailing Address - Phone:775-750-3730
Mailing Address - Fax:
Practice Address - Street 1:744 S 5TH ST STE 2
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-4291
Practice Address - Country:US
Practice Address - Phone:775-750-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI4061101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health