Active NPI
Jessica Nelson, LCSW
- Mental Health Counselor
- Forest Hills, NY
National Provider Identifier
1154565489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 075263
- Practice address
- 104 70 Queens Blvd
Suite 200
Forest Hills, NY 11375-3694 - Phone
- (718) 275-6010
- Fax
- (718) 275-6062
- NPI assigned
- Apr 30, 2009
- Sex
- Female
- Sole proprietor
- No
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 | 075263 | NY | Primary |
Addresses
Primary practice location
104 70 Queens Blvd
Suite 200
Forest Hills, NY 11375-3694
Mailing address
104 70 Queens Boulevard
Suite 200
Forest Hill, NY 11375-3694
Phone (718) 275-6010
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241049600000",
"number": "1154565489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 70 QUEENS BOULEVARD",
"address_2": "SUITE 200",
"city": "FOREST HILL",
"state": "NY",
"postal_code": "113753694",
"telephone_number": "718-275-6010",
"fax_number": "718-275-6062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 70 QUEENS BLVD",
"address_2": "SUITE 200",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113753694",
"telephone_number": "718-275-6010",
"fax_number": "718-275-6062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "JESSICA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-30",
"last_updated": "2009-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "075263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.