Healthcare Provider Details

I. General information

NPI: 1912861329
Provider Name (Legal Business Name): JG PSYCHOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3423 2ND AVE STE 3
KEARNEY NE
68847-2947
US

IV. Provider business mailing address

7 OAK LN
KEARNEY NE
68845-7605
US

V. Phone/Fax

Practice location:
  • Phone: 308-251-5464
  • Fax:
Mailing address:
  • Phone: 308-289-1026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. JESSICA GROSSNICKLAUS
Title or Position: PSYCHOLOGIST/OWNER
Credential: PSYD
Phone: 308-289-1026