Active NPI
Jessica Sue Pribila, CSW-I
- Mental Health Counselor
- Reno, NV
National Provider Identifier
1124795703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- IC-1790
- Practice address
- 421 W Plumb LN Ste B
Reno, NV 89509-3766 - Phone
- (775) 525-3400
- Fax
- (775) 525-3410
- NPI assigned
- Aug 23, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IC-1790 | NV | Primary |
Addresses
Primary practice location
421 W Plumb LN Ste B
Reno, NV 89509-3766
Mailing address
421 W Plumb LN Ste B
Reno, NV 89509-3766
Phone (775) 525-3400
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IC-1790 | NV | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grounded Roots Therapy | Multi-Specialty | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629676800000",
"number": "1124795703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "421 W PLUMB LN STE B",
"city": "RENO",
"state": "NV",
"postal_code": "895093766",
"telephone_number": "775-525-3400",
"fax_number": "775-525-3410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 W PLUMB LN STE B",
"city": "RENO",
"state": "NV",
"postal_code": "895093766",
"telephone_number": "775-525-3400",
"fax_number": "775-525-3410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIBILA",
"first_name": "JESSICA",
"middle_name": "SUE",
"credential": "CSW-I",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-23",
"last_updated": "2021-08-23",
"certification_date": "2021-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "NV",
"license": "IC-1790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.