Individual provider Active NPI

Jessie S. Hartman, M.S.W

  • Mental Health Counselor
  • Williamsport, PA
National Provider Identifier
1104051671
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
Diakon Family Life Services
435 W. Fourth Street
Williamsport, PA 17701
Phone
(570) 322-7873
Fax
(570) 322-8026
NPI assigned
May 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

Diakon Family Life Services
435 W. Fourth Street
Williamsport, PA 17701

Mailing address

Diakon Family Life Services
1800 W. Market Street
Lewisburg, PA 17837
Phone (570) 524-9477

Other identifiers 1

IdentifierTypeStateIssuer
1007777400036MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20181212000341 PA Practitioner - Clinical Social Worker 6901140359 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willow Tree Wellness and Counseling LLCGroup PAC ID 6103275508, 3 clinicians

Practice addresses (Care Compare)

1005 Scott Town Ctr
Suite 1012
Bloomsburg, PA 17815-2356
Phone (570) 317-2999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Tree Wellness & Counseling, LLC CurrentSince Dec 1, 2023 Accepting new patients
Geisinger Clinic CurrentSince Oct 20, 2018 Accepting new patients
Geisinger Clinic CurrentSince Oct 20, 2018 Accepting new patients
Geisinger Clinic Current Accepting new patients

Locations

1005 Scott Town Ctr
Bloomsburg, PA 17815
Phone (570) 317-2999

100 N Academy Ave
Danville, PA 17822

410 Mill St
Orangeville, PA 17859

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243468800000",
    "number": "1104051671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DIAKON FAMILY LIFE SERVICES",
            "address_2": "1800 W. MARKET STREET",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "17837",
            "telephone_number": "570-524-9477",
            "fax_number": "570-924-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DIAKON FAMILY LIFE SERVICES",
            "address_2": "435 W. FOURTH STREET",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "17701",
            "telephone_number": "570-322-7873",
            "fax_number": "570-322-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "JESSIE",
        "middle_name": "S.",
        "credential": "M.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-27",
        "last_updated": "2009-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007777400036",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.