Jessica Ashley Blum, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2018012458 Issued in MO

Practice address

820 Park Dr
Ste Genevieve, MO 63670-1566

Phone

(573) 883-7407

Fax

(573) 883-7537

NPI assigned

Apr 26, 2018

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 identifiers 1

Other names 1

• Miss Jessica Ashley Franklin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1285122002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 PARK DR",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "636701566",
            "telephone_number": "573-883-7407",
            "fax_number": "573-883-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 PARK DR",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "636701566",
            "telephone_number": "573-883-7407",
            "fax_number": "573-883-7537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "JESSICA",
        "middle_name": "ASHLEY",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-26",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2018012458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490053268",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "FRANKLIN",
            "middle_name": "ASHLEY",
            "prefix": "MISS",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Ste Genevieve, MO
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.

Verify at the official NPI Registry.