Individual provider Active NPI

Jessica Heaton, MAMHC

  • Mental Health Counselor
  • Philadelphia, PA
National Provider Identifier
1225537251
Registry record updated Feb 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
6122 Ridge Ave
Philadelphia, PA 19128-1603
Phone
(609) 420-2103
NPI assigned
Feb 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

6122 Ridge Ave
Philadelphia, PA 19128-1603

Mailing address

102 Maplewood Dr Apt a
Maple Shade, NJ 08052-1971
Phone (609) 420-2103

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1225537251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MAPLEWOOD DR APT A",
            "city": "MAPLE SHADE",
            "state": "NJ",
            "postal_code": "080521971",
            "telephone_number": "609-420-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6122 RIDGE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281603",
            "telephone_number": "609-420-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATON",
        "first_name": "JESSICA",
        "credential": "MAMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-05",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; 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.