Individual provider Active NPI

Jemma Chong Qui, LCADC, MA

Counselor
Baltimore, MD

National Provider Identifier

1114261450

Registry record updated Apr 19, 2024

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices1
NPI Registry JSON
Other providers in Baltimore, MD
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: CounselorTaxonomy code 101Y00000X
Practice address: 5005 Morello Rd
Baltimore, MD 21214-2121
Phone: (443) 530-6533
NPI assigned: Nov 26, 2012
Sex: Female
Sole proprietor: Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 8

Specialty (taxonomy)	Code	License	State	Primary
Counselor	101Y00000X	LCADC	MD
Counselor	101Y00000X	LCA390	MD
Addiction (Substance Use Disorder) Counselor	101YA0400X	LCADC	MD
Addiction (Substance Use Disorder) Counselor	101YA0400X
Mental Health Counselor	101YM0800X	LCADC	MD
Professional Counselor	101YP2500X
Professional Counselor	101YP2500X	LCADC	MD
Counselor	101Y00000X			Primary

Addresses

Primary practice location

5005 Morello Rd
Baltimore, MD 21214-2121

Mailing address

5005 Morello Rd
Baltimore, MD 21214-2123
Phone (410) 303-9229

Other identifiers 2

Identifier	Type	State	Issuer
1063066397	Medicaid	MD
1114261450	Medicaid	MD

Electronic endpoints 11

Type	Endpoint	Use
CONNECT URL	Network	Health Information Exchange (HIE)
CONNECT URL	Baltimore	Direct
CONNECT URL	Internet	Health Information Exchange (HIE)
CONNECT URL	Computer	Health Information Exchange (HIE)
CONNECT URL	Network	Health Information Exchange (HIE)
CONNECT URL	Baltimore	Direct
CONNECT URL	Network	Health Information Exchange (HIE)
CONNECT URL	Network	Health Information Exchange (HIE)
CONNECT URL	Computer	Health Information Exchange (HIE)
CONNECT URL	Baltimore	Direct
CONNECT URL	Baltimore	Direct

Medicare participation

Medicare enrollment files

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

National Provider Directory

Medicare enrollment (NPD): Not enrolled
Credentials: Master of Arts

State licenses

License	State	Type	Specialty
LCA390	MD	MD	Counselor
LCADC	MD	MD	Counselor

Practice roles

Organization	Specialty	Status	New patients
Jems Counseling and Clinical Supervision Services LLC		CurrentSince Aug 1, 2019	Accepting new patients

Locations

5224 Harford Rd
Ste B
Baltimore, MD 21214
Phone (410) 303-9229

Organizations & group practices 1

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.

Jems Counseling and Clinical Supervision Services LLC
- Adult Mental Health Clinic/Center
- Baltimore, MD
- NPI 1063066397
NPD Authorized official

NPI Registry JSON

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1114261450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 MORELLO RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212142123",
            "telephone_number": "410-303-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 MORELLO RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212142121",
            "telephone_number": "443-530-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG QUI",
        "first_name": "JEMMA",
        "credential": "LCADC, MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "LCADC",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "LCA390",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCADC",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LCADC",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LCADC",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063066397",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114261450",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Network",
            "affiliation": "N",
            "endpointDescription": "provide Counseling and Clinical Supervisor",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5224 Harford Rd Ste B",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212142694",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Baltimore",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5224 Harford Rd",
            "address_2": "Suite B",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "21214",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Internet",
            "affiliation": "N",
            "endpointDescription": "Share Drive",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5224 Harford Rd Ste B",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212142694",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Computer",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "5224 Harford Rd",
            "address_2": "Suite B",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "21214",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Network",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5224 Harford Rd Ste B",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212142694",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Baltimore",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5224 Harford Rd Ste B",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212142694",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Network",
            "affiliation": "N",
            "endpointDescription": "Provide Counseling and Clinical Supervision",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5005 Morello Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212142121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Network",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5005 Morello Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212142121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Computer",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "5005 Morello Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212142123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Baltimore",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5005 Morello Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212142121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Baltimore",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5005 Morello Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212142121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.