Individual provider Active NPI

Jessica Elizabeth Whittington, LCSW

  • Mental Health Counselor
  • New Bern, NC
National Provider Identifier
1003154634
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CO14896 Issued in NC
Practice address
3402 Trent Rd
New Bern, NC 28562-2232
Phone
(209) 445-4369
Fax
(252) 634-9332
NPI assigned
Jan 16, 2013
Last updated
Dec 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCSW94934 CA
Mental Health Counselor 101YM0800X CO14896 NC Primary

Addresses

Primary practice location

3402 Trent Rd
New Bern, NC 28562-2232

Mailing address

213 Lynden LN
New Bern, NC 28560-8556
Phone (209) 445-4369

Other practice location 1

213 Lynden Ln
New Bern, NC 28560-8556
Phone (209) 445-4369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240422002782 NC Practitioner - Clinical Social Worker 1456790500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inner Source Therapy PLLCGroup PAC ID 1153771787, 4 clinicians

Practice addresses (Care Compare)

2407 Grace Ave
New Bern, NC 28562-4416
Phone (252) 514-7766

3402 Trent Rd
New Bern, NC 28562-2232
Phone (252) 571-6508

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW94934CAMDMental Health Counselor
CO14896NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Source Therapy, PLLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Telecare Corporation Past Accepting new patients
A Fresh Start Behavioral Health Services, PLLC PastSince Jun 1, 2022 Accepting new patients

Locations

3402 Trent Rd
New Bern, NC 28562
Phone (252) 571-6508

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1003154634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 LYNDEN LN",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285608556",
            "telephone_number": "209-445-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 TRENT RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622232",
            "telephone_number": "209-445-4369",
            "fax_number": "252-634-9332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "213 Lynden Ln",
            "address_purpose": "LOCATION",
            "city": "New Bern",
            "state": "NC",
            "postal_code": "285608556",
            "country_code": "US",
            "telephone_number": "209-445-4369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITTINGTON",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LCSW94934",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "CO14896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

Verify at the official NPI Registry.