Jessica Pentecost

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

18179 Issued in NY

Practice address

11 Farber Dr
Bellport, NY 11713-1500

Phone

(631) 286-0700

NPI assigned

Nov 7, 2008

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

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.

• Outreach Development Corporation

  • Addiction (Substance Use Disorder) Counselor
  • Richmond Hill, NY
  • NPI 1083717326
  NPD (past)

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226016000000",
    "number": "1164676805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 FARBER DR",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117131500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 FARBER DR",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117131500",
            "telephone_number": "631-286-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTECOST",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-07",
        "last_updated": "2008-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "18179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlese Ji-Ara Pannell
• Maryann Parbus, RN
• Roodal L Partap
• Peemed Express Care LLC
• Bettina Pennon, CASAC
• Sarah Perrino
• Yolette Pierre
• Kim Denise Potter, LPN
• Courtney Prada, OTR/L
• Professional Corporation

• Addiction (Substance Use Disorder) Counselor in Bellport, NY
• Providers in Bellport, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2008; 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.