Jessica Elaine Pendergast, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC015072 Issued in PA

Practice address

865 Easton Rd Ste 180
Warrington, PA 18976-1879

Phone

(215) 999-4724

Fax

(267) 762-4368

NPI assigned

Dec 6, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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

• Within the Fragments LLC

  • Mental Health Counselor
  • Holland, PA
  • NPI 1780384735
  NPD Authorized official
• Omni Health Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Upper Darby, PA
  • NPI 1831236637
  NPD (past)

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1053022590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W PATRICIA RD",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189661828",
            "telephone_number": "215-378-7529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 EASTON RD STE 180",
            "city": "WARRINGTON",
            "state": "PA",
            "postal_code": "189761879",
            "telephone_number": "215-999-4724",
            "fax_number": "267-762-4368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 W Patricia Rd",
            "address_purpose": "LOCATION",
            "city": "Southampton",
            "state": "PA",
            "postal_code": "189661828",
            "country_code": "US",
            "telephone_number": "267-209-3435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENDERGAST",
        "first_name": "JESSICA",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC015072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jpendergast@wtftherapy.net",
            "affiliation": "N",
            "address_1": "117 W Patricia Rd",
            "city": "Southampton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "189661828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chirag Patel, D.M.D
• Partha Bhasker Patel, D.D.S.
• Reena Patel
• Sneh Pravin Patel, PHARMD
• Kelley Anne Peloquin, ATC/L
• Pennsylvania CVS Pharmacy LLC
• Kiara Peralta, MA, LPC
• Andrew Persky, D.C.
• Shari L Pescatore, LPC
• Peter Fazio Inc

• Professional Counselor in Warrington, PA
• Providers in Warrington, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.