MEDICARE: MRS. JESSIE LYNN KORTE LMSW-C

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	1041C0700X	Clinical Social Worker	6801090369	MI

General Provider Information

NPI Number	:	1588069280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSIE LYNN KORTE LMSW-C

Provider Business Mailing Address
First Line	:	25655 24 MILE RD
Second Line	:
City	:	CHESTERFIELD
State	:	MI
Zip	:	48051-1527
Country	:	US
Telephone Number	:	586-371-2455
Fax Number	:	586-371-2455

Provider Business Practice Location Address
First Line	:	25655 24 MILE RD
Second Line	:
City	:	CHESTERFIELD
State	:	MI
Zip	:	48051-1527
Country	:	US
Telephone Number	:	586-371-2455
Fax Number	:	586-371-2455

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2014
Last Update Date	:	03/06/2026

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