TIANA JESSUP


Address: 3629 Pearlbush Ave, Apt 2, Indianapolis, IN 46203-6704
Phone: 3175400373

TIANA JESSUP (NPI# 1932552841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932552841
Entity Type Individual
Full Name TIANA JESSUP
Credential M.S
Practice Address 3629 Pearlbush Ave
Apt 2
Indianapolis
IN 46203-6704
Practice Telephone 3175400373
Mailing Telephone 3175400373
Enumeration Date 2016-07-14
Last Update Date 2017-10-22
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101Y00000X Counselor Behavioral Health & Social Service Providers
Y 101YM0800X Counselor
Specialization: Mental Health
Behavioral Health & Social Service Providers
N 171W00000X Contractor Other Service Providers

Office Location

Street Address 3629 PEARLBUSH AVE
APT 2
City INDIANAPOLIS
State IN
Zip Code 46203-6704

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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City INDIANAPOLIS
Zip Code 46203

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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