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NPI Code Detail

MEDICARE: MRS. JESSICA ANN MASSEKE-HARVEY LCSW

MEDICARE: MRS. JESSICA ANN MASSEKE-HARVEY LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker106297TX

General Provider Information

NPI Number : 1023798360
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JESSICA ANN MASSEKE-HARVEY LCSW
Provider Business Mailing Address
First Line : 1205 S WHITE CHAPEL BLVD STE 265
Second Line : STE 265
City : SOUTHLAKE
State : TX
Zip : 76092-9331
Country : US
Telephone Number : 817-800-4241
Fax Number :
Provider Business Practice Location Address
First Line : 1500 COOPER ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2710
Country : US
Telephone Number : 828-854-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2023
Last Update Date : 06/12/2026

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