Provider Demographics
NPI:1033922398
Name:ATKINS, JESSICA LINDSAY (LSSP)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LINDSAY
Last Name:ATKINS
Suffix:
Gender:F
Credentials:LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7528 SOMERVELL ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76120-2498
Mailing Address - Country:US
Mailing Address - Phone:817-456-3479
Mailing Address - Fax:
Practice Address - Street 1:1200 CIRCLE DR STE 400B
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76119-8112
Practice Address - Country:US
Practice Address - Phone:817-569-4750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70025103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool