Healthcare Provider Details

I. General information

NPI: 1316422298
Provider Name (Legal Business Name): JESSICA HASANBEGOVIC LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA RYAN

II. Dates (important events)

Enumeration Date: 09/26/2018
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15800 SUMMIT PLZ
BENNINGTON NE
68007-1509
US

IV. Provider business mailing address

15800 SUMMIT PLZ
BENNINGTON NE
68007-1509
US

V. Phone/Fax

Practice location:
  • Phone: 531-299-9656
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number4831
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number1666
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: