Jenna Gazzillo, MHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

6 Wellness Way Ste 112
Latham, NY 12110-2156

Phone

(518) 881-1109

Fax

(518) 213-6985

NPI assigned

May 18, 2021

Last updated

Feb 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jenna Grady Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennagazzillo@ccp.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Care Physicians, PLLC

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1922048370

  Family Medicine

  Medicare reassignment NPD
• Community Care Physicians, PLLC

  dba CCP Integrated Behavioral Health

  • Mental Health Counselor
  • Latham, NY
  • NPI 1578329355
  NPD

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1417521980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 112",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-881-1109",
            "fax_number": "518-213-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZZILLO",
        "first_name": "JENNA",
        "credential": "MHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-18",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "GRADY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rosemary L Gardner, PA
• Mara Arielle Garfinkel, PHARMD
• Jenny Garneau
• Keith Chris Garneau
• Wendy Gaughan, OTR
• Nicole Geary
• Danielle Gecewicz
• Igor Genov, D.O.
• Brian Matthew Gentile, LMHC, CRC
• Geo Medicab Inc

• Mental Health Counselor in Latham, NY
• Providers in Latham, 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 Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.