Jacquelyn Deshong, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

001698-01 Issued in NY

Practice address

16701 Melford Blvd
Bowie, MD 20715-4305

Phone

(844) 830-7233

NPI assigned

Jun 23, 2022

Last updated

Jun 23, 2022By the provider in NPPES

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

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

Specialty

Marriage and Family Therapist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Truenorth Wellness ServicesGroup PAC ID 6709869456, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24036/brand/1/csg/1/fhir/r4

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.

• Truenorth Wellness Services

  • Community/Behavioral Health Agency
  • Hanover, PA
  • NPI 1912013509
  Medicare reassignment Care Compare group NPD
• Truenorth Wellness Services

  • Community/Behavioral Health Agency
  • Hanover, PA
  • NPI 1356534945
  NPD
• Truenorth Wellness Services

  • Community/Behavioral Health Agency
  • Hanover, PA
  • NPI 1447443049
  NPD
• Vita Health Services, LLPC

  • Clinical Social Worker
  • New Haven, CT
  • NPI 1083385777
  NPD
• Vita Health Services, PLLC

  dba Vita Health

  • Clinical Social Worker
  • West Hartford, CT
  • NPI 1265047799

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1124759766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SCIENCE PARK",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065111962",
            "telephone_number": "844-830-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16701 MELFORD BLVD",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154305",
            "telephone_number": "844-830-7233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Park Ave S",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100168808",
            "country_code": "US",
            "telephone_number": "844-830-7233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESHONG",
        "first_name": "JACQUELYN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "001698-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Bowie, MD
• Providers in Bowie, MD by specialty
• Marriage & Family Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.