Jennifer Jillian Banning
Individual provider Active NPI Professional Counselor · Vernon, CT
NPI 1326401910 · NPPES record last updated Dec 13, 2021
Key facts
- NPI
- 1326401910
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 4013 (CT)
- Practice address
- 31 Union St
Vernon, CT 06066-3126 - Phone
- (860) 872-0501
- Fax
- (860) 872-5380
- NPI assigned
- Mar 31, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mansfield Mental Health and Addiction Medicine
Practice addresses (Care Compare)
207 Storrs Rd
Mansfield Center, CT 06250-1638
Phone (860) 942-8830
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250624000638 | CT | Practitioner - Mental Health Counselor | 4082126230 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mansfield Mental Health and Addiction Medicine | Current |
Accepting new patients | |
| Habit Opco | Addiction (Substance Use Disorder) | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Professional Counselor | 101YP2500X | 4013 | CT | Yes |
Addresses
Primary practice location
31 Union St
Vernon, CT 06066-3126
Mailing address
31 Union St
Vernon, CT 06066-3126
Phone (860) 872-0501
Other providers in Vernon, CT
- Axen Behavioral Health PLLC
- Angelito C Bacay
- Jigisha Jigar Badgujar
- Laurie Ann Bain
- Erin Kathleen Bamback
- Barbara Pascal-Gladstone Aprn, LLC
- Kathryn E Barnes
- Laura Barnhart
- Patricia Cosgrove Barresi
- Barry W Haight MD
All providers in Vernon, CT · Professional Counselor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.