Jessica Miserentino, M.ED., LAC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

37AC00336000 Issued in NJ

Practice address

130 Sand Shore Rd
Budd Lake, NJ 07828-1506

Phone

(862) 432-9047

NPI assigned

Mar 18, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1489795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489795200000",
    "number": "1104367556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SAND SHORE RD",
            "city": "BUDD LAKE",
            "state": "NJ",
            "postal_code": "078281506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 SAND SHORE RD",
            "city": "BUDD LAKE",
            "state": "NJ",
            "postal_code": "078281506",
            "telephone_number": "862-432-9047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISERENTINO",
        "first_name": "JESSICA",
        "credential": "M.ED., LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-18",
        "last_updated": "2017-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "37AC00336000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Budd Lake, NJ
• Providers in Budd Lake, NJ by specialty
• Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2017; 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.