Active NPI
Jessica Rae Buczek, MS, LPCC
- Mental Health Counselor
- Dayton, OH
National Provider Identifier
1255792990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- E.1800567
- Practice address
- 30 W Rahn Rd Ste 26
Dayton, OH 45429-2291 - Phone
- (937) 479-2793
- NPI assigned
- Mar 8, 2016
- Last updated
- Jun 2, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C.0900463 | OH | |
| Mental Health Counselor | 101YM0800X | E.1800567 | OH | Primary |
Addresses
Primary practice location
30 W Rahn Rd Ste 26
Dayton, OH 45429-2291
Mailing address
30 W Rahn Rd Ste 26
Dayton, OH 45429-2291
Phone (937) 479-2793
Other practice location 1
267 Regency Ridge Dr
Dayton, OH 45459-4221
Phone (937) 396-7077
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E.1800567 | OH | MD | Mental Health Counselor |
| C.0900463 | OH | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Reflections Counseling, Inc. | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591056000000",
"number": "1255792990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 W RAHN RD STE 26",
"city": "DAYTON",
"state": "OH",
"postal_code": "454292291",
"telephone_number": "937-479-2793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 W RAHN RD STE 26",
"city": "DAYTON",
"state": "OH",
"postal_code": "454292291",
"telephone_number": "937-479-2793"
}
],
"practiceLocations": [
{
"address_1": "267 Regency Ridge Dr",
"address_purpose": "LOCATION",
"city": "Dayton",
"state": "OH",
"postal_code": "454594221",
"country_code": "US",
"telephone_number": "937-396-7077",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUCZEK",
"first_name": "JESSICA",
"middle_name": "RAE",
"name_prefix": "Mrs.",
"credential": "MS, LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-08",
"last_updated": "2020-06-02",
"certification_date": "2020-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "C.0900463",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E.1800567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.