Individual provider Active NPI

Jessica Lee Van Haaften

  • Professional Counselor
  • Knoxville, TN
National Provider Identifier
1114741147
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5921 Issued in TN
Practice address
9111 Cross Park Dr Ste E-285
Knoxville, TN 37923-4506
Phone
(865) 290-0211
Fax
(865) 951-7308
NPI assigned
Nov 15, 2024
Last updated
Nov 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5921 TN Primary

Addresses

Primary practice location

9111 Cross Park Dr Ste E-285
Knoxville, TN 37923-4506

Mailing address

9111 Cross Park Dr Ste E-285
Knoxville, TN 37923-4506
Phone (865) 290-0211

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

Practice roles

OrganizationSpecialtyStatusNew patients
Insightful Journey Therapy Services PLLC Professional CurrentSince Nov 17, 2024 Accepting new patients

Locations

9111 Cross Park Dr
Ste E285
Knoxville, TN 37923
Phone (865) 290-0211

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1731628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1114741147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9111 CROSS PARK DR STE E-285",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234506",
            "telephone_number": "865-290-0211",
            "fax_number": "865-951-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9111 CROSS PARK DR STE E-285",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234506",
            "telephone_number": "865-290-0211",
            "fax_number": "865-951-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HAAFTEN",
        "first_name": "JESSICA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "5921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.