Jennifer A Skruck, PCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E0008479-S Issued in OH

Practice address

365 Riffel Rd Ste B
Wooster, OH 44691-8592

Phone

(330) 345-3461

Fax

(330) 345-3462

NPI assigned

Oct 9, 2007

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

Other names 1

• Ms. Jennifer A Yates Former name

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bloomington Medical Services LLCGroup PAC ID 9032297627, 106 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Bloomington Medical Services LLC

  • Internal Medicine Physician
  • Wooster, OH
  • NPI 1528246683
  Medicare reassignment Care Compare group NPD
• Cornerstone Psychological & Counseling Services of Northeast Ohio

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Medina, OH
  • NPI 1144612300
  Medicare reassignment NPD
• Bowden & Associates Psychological and Counseling Services LLC

  • Clinical Psychologist
  • Wooster, OH
  • NPI 1689111882
  NPD

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1205024957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 RIFFEL RD STE B",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446918592",
            "telephone_number": "330-345-3461",
            "fax_number": "330-345-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 RIFFEL RD STE B",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446918592",
            "telephone_number": "330-345-3461",
            "fax_number": "330-345-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKRUCK",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0008479-S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "YATES",
            "middle_name": "A",
            "prefix": "MS.",
            "credential": "PCC-S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kentrell L Skeens
• William J Skelly, M.D.
• Shawn D Skelton
• Asia Skipper
• Michele Schmidt Skolnicki, MA, PHD, LPCC
• James Alan Slaby, M.D.
• Angela Slarb
• Julia A Sliemers, QMHS 3YRS CMS
• Lessie Sloan
• Antonella Slone

• Professional Counselor in Wooster, OH
• Providers in Wooster, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.