Provider Demographics
NPI:1487473336
Name:NEIDERHISER, JESSICA ANNE (LPC, T-LPC)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:ANNE
Last Name:NEIDERHISER
Suffix:
Gender:F
Credentials:LPC, T-LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11310 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64137-2342
Mailing Address - Country:US
Mailing Address - Phone:816-255-7491
Mailing Address - Fax:
Practice Address - Street 1:8629 BLUEJACKET
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66214
Practice Address - Country:US
Practice Address - Phone:913-677-3553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04753101YM0800X
KS04753-T101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health