Individual provider Active NPI

Jill Rzasa-Lane, M.A., LCMHC

  • Mental Health Counselor
  • Rochester, NH
National Provider Identifier
1114235249
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2259 Issued in NH
Practice address
15 Broad St
Rochester, NH 03867-3409
Phone
(603) 682-3235
NPI assigned
Sep 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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
Mental Health Counselor 101YM0800X 2259 NH Primary

Addresses

Primary practice location

15 Broad St
Rochester, NH 03867-3409

Mailing address

15 Broad St
Rochester, NH 03867-3409
Phone (603) 682-3235

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2259NHMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1114235249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BROAD ST",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038673409",
            "telephone_number": "603-682-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BROAD ST",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038673409",
            "telephone_number": "603-682-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RZASA-LANE",
        "first_name": "JILL",
        "credential": "M.A., LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-23",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "2259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.