Jessica Susan Hibbs, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC11740 Issued in MD

Practice address

10026 Main St BLDG 1
Berlin, MD 21811-3206

Phone

(410) 973-2211

Fax

(443) 782-0350

NPI assigned

Jul 31, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ms. Jessica Susan Diaz Former name

Electronic endpoints 1

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 and National Provider Directory roles.

• Lighthouse Counseling Christian Ministry, LLC

  • Professional Counselor
  • Berlin, MD
  • NPI 1104272426
  NPD

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1194379784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10026 MAIN ST BLDG 1",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113206",
            "telephone_number": "410-973-2211",
            "fax_number": "443-782-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10026 MAIN ST BLDG 1",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113206",
            "telephone_number": "410-973-2211",
            "fax_number": "443-782-0350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1813 Sweetbay Dr",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218041663",
            "country_code": "US",
            "telephone_number": "410-219-5483",
            "fax_number": "410-219-5486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIBBS",
        "first_name": "JESSICA",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "LGP9764",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC11740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "LC11740",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhibbs@lighthousecounselingcm.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "10026 Main St Bldg 1",
            "city": "Berlin",
            "state": "MD",
            "country_code": "US",
            "postal_code": "218113206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "DIAZ",
            "middle_name": "SUSAN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Healthy Connections Physical Therapy & Wellness, LLC
• Joshua C Hefta
• Laura S Hernandez
• Jessica Hesling, BCBA
• Connor Hibbs
• Jennifer Hickman, MAC., LAC.
• Jordan Rae Hines, PHARMD
• Megan Hines, CPSC
• Jacquelyn Nicole Hirsch, LCSW-C
• Katelyn Hitch, PHARMD

• Professional Counselor in Berlin, MD
• Providers in Berlin, MD by specialty
• Professional Counselor in Maryland

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