Healthcare Provider Details

I. General information

NPI: 1922556497
Provider Name (Legal Business Name): JESSICA LYNN HYNSON MA, CSAYC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA LYNN NIKSICH MA

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5892 CHAZIMAL ST
PLAINFIELD IN
46168-8521
US

IV. Provider business mailing address

5892 CHAZIMAL ST
PLAINFIELD IN
46168-8521
US

V. Phone/Fax

Practice location:
  • Phone: 219-617-8268
  • Fax:
Mailing address:
  • Phone: 219-617-8268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39002926A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: