Jessica Ambrose, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC013909 Issued in PA

Practice address

1820 Linglestown Rd
Harrisburg, PA 17110-3339

Phone

(717) 202-2510

NPI assigned

Oct 28, 2021

Last updated

Oct 28, 2021By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Water's Edge Counseling Center, LLC

  • Professional Counselor
  • Mechanicsburg, PA
  • NPI 1821870866
  NPD Authorized official

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1154085850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2958 MERIDIAN LN APT 6",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170556914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 LINGLESTOWN RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171103339",
            "telephone_number": "717-202-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "JESSICA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC013909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Professional Counselor in Pennsylvania

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