Elise N Jarvis

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MHC01020 Issued in RI

Practice address

24 Salt Pond Rd Ste H1
Wakefield, RI 02879-4337

Phone

(401) 789-3694

NPI assigned

Jan 22, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Delta Consultants of South County Inc

  • Counselor
  • Wakefield, RI
  • NPI 1194877621
  NPD (past)

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1306300512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 MERINO ST",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029194417",
            "telephone_number": "973-600-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 SALT POND RD STE H1",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028794337",
            "telephone_number": "401-789-3694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "ELISE",
        "middle_name": "N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC01020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Innovative Works
• Elizabeth Bogardus Ison, LICSW SOCIAL WORKER
• Sherry Jackson, LICSW
• Susan Charlotte Jacobsen, LMHC
• James F. Griffin
• Jee Q. Liang, M.D
• Caroline H. Jenckes, CRNP
• John D. Graham M.D.
• John Jefferys Bandola, M.D.
• John L Bossian

• All providers in Wakefield, RI
• Mental Health Counselor in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.