Jessica Lenore Ackley

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P119505 Issued in NY

Practice address

1129 Kenmore Ave
Kenmore, NY 14217-2845

Phone

(716) 217-0010

NPI assigned

Apr 24, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Kind Mental Health Counselors, PLLC

  • Mental Health Counselor
  • Kenmore, NY
  • NPI 1053020347
  NPD

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1386331817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 KENMORE AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142172845",
            "telephone_number": "716-217-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 KENMORE AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142172845",
            "telephone_number": "716-217-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKLEY",
        "first_name": "JESSICA",
        "middle_name": "LENORE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P119505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Kenmore, NY
• Providers in Kenmore, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; 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.