Individual provider Active NPI

Jessica Dahlgren, MS, NCC, LPC

  • Professional Counselor
  • Erie, PA
National Provider Identifier
1285496653
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC016631 Issued in PA
Practice address
4320 Dexter Ave
Erie, PA 16504-2444
Phone
(814) 825-2930
NPI assigned
Jan 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC016631 PA Primary

Addresses

Primary practice location

4320 Dexter Ave
Erie, PA 16504-2444

Mailing address

20387 Alden St
Meadville, PA 16335-4117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20240311002276 PA Practitioner - Mental Health Counselor 1850737073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Abcs of Building Better Lives LLCGroup PAC ID 9931367950, 16 clinicians

Practice addresses (Care Compare)

4320 Dexter Ave
Eric, PA 16504-2444
Phone (814) 825-2930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PC016631PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Abcs of Building Better Lives LLC Professional CurrentSince Feb 6, 2024 Accepting new patients

Locations

4320 Dexter Ave
Erie, PA 16504
Phone (814) 825-2930

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1285496653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20387 ALDEN ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163354117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 DEXTER AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165042444",
            "telephone_number": "814-825-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLGREN",
        "first_name": "JESSICA",
        "credential": "MS, NCC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC016631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.