Provider Demographics
NPI:1912861329
Name:JG PSYCHOLOGY, LLC
Entity type:Organization
Organization Name:JG PSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSSNICKLAUS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:308-289-1026
Mailing Address - Street 1:7 OAK LN
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-7605
Mailing Address - Country:US
Mailing Address - Phone:308-289-1026
Mailing Address - Fax:
Practice Address - Street 1:3423 2ND AVE STE 3
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2947
Practice Address - Country:US
Practice Address - Phone:308-251-5464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-10
Last Update Date:2025-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)