MEDICARE: JESSICA ZIEKY LICSW LLC

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
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1295694925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JESSICA ZIEKY LICSW LLC

Provider Business Mailing Address
First Line	:	11 ROBINWOOD AVE
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02492-2112
Country	:	US
Telephone Number	:	508-492-5020
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 ROBINWOOD AVE
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02492-2112
Country	:	US
Telephone Number	:	508-492-5020
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESSICA TYE ZIEKY
Credential	:	LICSW
Telephone Number	:	857-829-0089

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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