Individual provider Active NPI

Jessica A Wheeler, ADS, CRSW

  • Addiction (Substance Use Disorder) Counselor
  • Manchester, NH
National Provider Identifier
1043923915
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
0190 Issued in NH
Practice address
20 Market St
Manchester, NH 03101-1957
Phone
(603) 487-6727
Fax
(603) 622-7328
NPI assigned
Jan 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0190 NH Primary

Addresses

Primary practice location

20 Market St
Manchester, NH 03101-1957

Mailing address

50 Webster St # 2
Manchester, NH 03104-2504
Phone (603) 851-4756

Other practice location 1

700 Lake Ave Ste 2
Manchester, NH 03103-2734
Phone (603) 263-6288

Other practice location 2

140 Queen City Ave
Manchester, NH 03103-7122
Phone (603) 263-6288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0190NHMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1043923915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 WEBSTER ST # 2",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042504",
            "telephone_number": "603-851-4756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MARKET ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011957",
            "telephone_number": "603-487-6727",
            "fax_number": "603-622-7328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Lake Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031032734",
            "country_code": "US",
            "telephone_number": "603-263-6288",
            "fax_number": "603-621-4016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "140 Queen City Ave",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031037122",
            "country_code": "US",
            "telephone_number": "603-263-6288",
            "fax_number": "603-621-4016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "JESSICA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "ADS, CRSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NH",
            "license": "0190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.