Jae LLC

Primary specialty

DoulaTaxonomy code 374J00000X

Legal business name

JAE LLC

Doing business as

The Happy Mama Place

Practice address

512 Northhampton Street
Edwardsville, PA 18704

Phone

(570) 212-9520

NPI assigned

Dec 28, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Jessica Ann Enriquez, LMT

Title

Doula/Licensed Massage Therapist

Phone

(570) 299-9247

Specialties & licenses 2

Addresses

Other names 1

• The Happy Mama Place Doing business as

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

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482883200000",
    "number": "1376088435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 STOCKTON MOUNTAIN RD",
            "city": "BEAVER MEADOWS",
            "state": "PA",
            "postal_code": "182166505",
            "telephone_number": "570-299-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 NORTHHAMPTON STREET",
            "city": "EDWARDSVILLE",
            "state": "PA",
            "postal_code": "18704",
            "telephone_number": "570-212-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-28",
        "last_updated": "2016-12-28",
        "status": "A",
        "authorized_official_last_name": "ENRIQUEZ",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DOULA/LICENSED MASSAGE THERAPIST",
        "authorized_official_telephone_number": "570-299-9247",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "PA",
            "license": "MSG006829",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Happy Mama Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Doula in Edwardsville, PA
• Providers in Edwardsville, PA by specialty
• Doula in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; 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.