Jessica Lee Supperer, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC014795 Issued in PA

Practice address

2291 Cabot Blvd W
Langhorne, PA 19047-1806

Phone

(215) 642-3230

Fax

(215) 642-3234

NPI assigned

Aug 17, 2022

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 and National Provider Directory roles.

• Aldie Foundation

  dba Aldie Counseling Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Langhorne, PA
  • NPI 1134342165
  NPD (past)

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1174241020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 STANTON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291618",
            "telephone_number": "215-260-3465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2291 CABOT BLVD W",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471806",
            "telephone_number": "215-642-3230",
            "fax_number": "215-642-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPPERER",
        "first_name": "JESSICA",
        "middle_name": "LEE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-17",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC014795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; 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.