Jessica Ann Nelson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LICDC161554 Issued in OH

Practice address

2863 State Route 45 N
Rock Creek, OH 44084-9352

Phone

(440) 710-3248

NPI assigned

May 12, 2020

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

Electronic endpoints 1

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.

• Glenbeigh

  dba Glenbeigh Health Sources

  • Special Hospital
  • Rock Creek, OH
  • NPI 1790761922
  NPD (past)

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1407478480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 298",
            "city": "ROCK CREEK",
            "state": "OH",
            "postal_code": "440840298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2863 STATE ROUTE 45 N",
            "city": "ROCK CREEK",
            "state": "OH",
            "postal_code": "440849352",
            "telephone_number": "440-710-3248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-12",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC161554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.nelson@glenbeigh.com",
            "affiliation": "N",
            "endpointDescription": "work address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2863 State Route 45 N",
            "city": "Rock Creek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440849352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole Lunato, LCDC II
• Molly Elizabeth Martin, M.S. CCC-SLP
• Kassandra McNaughton
• Samantha Miner, LSW
• Jonathan Matthew Moldovan, CNP
• Tanya Niemi
• Sarah Renee Ozimec, BA, CDCA
• Christopher Pendleton
• Sheila Renee Peto, LICDC, LSW
• Anne Phillipp

• Addiction (Substance Use Disorder) Counselor in Rock Creek, OH
• Providers in Rock Creek, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.