Active NPI
Jacquelyn Ball
- Counselor
- Worcester, MA
National Provider Identifier
1275127870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 20022
- Practice address
- 95 Lincoln St
Worcester, MA 01605-2441 - Phone
- (508) 453-3053
- NPI assigned
- Feb 24, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 20022 | MA | Primary |
Addresses
Primary practice location
95 Lincoln St
Worcester, MA 01605-2441
Mailing address
95 Lincoln St
Worcester, MA 01605-2441
Phone (508) 453-3053
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240227004317 | MA | Practitioner - Mental Health Counselor | 3072958271 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20022 | MA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614124800000",
"number": "1275127870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 LINCOLN ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052441",
"telephone_number": "508-453-3053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 LINCOLN ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052441",
"telephone_number": "508-453-3053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALL",
"first_name": "JACQUELYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-24",
"last_updated": "2021-02-24",
"certification_date": "2021-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MA",
"license": "20022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.