Jessica Hamm, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.181986 Issued in OH

Practice address

7175 State Route 104
MC Dermott, OH 45652-8899

Phone

(740) 858-6683

NPI assigned

Oct 21, 2022

Last updated

Oct 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Moving Forward Residential LLC

  • Community/Behavioral Health Agency
  • McDermott, OH
  • NPI 1811767684
  NPD
• Moving Forward Residential LLC

  • Community/Behavioral Health Agency
  • McDermott, OH
  • NPI 1871016691
  NPD (past)

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1417674342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402",
            "city": "WHEELERSBURG",
            "state": "OH",
            "postal_code": "456940402",
            "telephone_number": "740-858-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7175 STATE ROUTE 104",
            "city": "MC DERMOTT",
            "state": "OH",
            "postal_code": "456528899",
            "telephone_number": "740-858-6683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9620 CAREYS RUN POND CREEK ROAD",
            "address_purpose": "LOCATION",
            "city": "MCDERMOTT",
            "state": "OH",
            "postal_code": "45652",
            "country_code": "US",
            "telephone_number": "740-858-6683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMM",
        "first_name": "JESSICA",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-21",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.181986",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002869",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beth Groves, L.P.N.
• Delores Hall, STNA
• Michael Hall
• Nicholas L Hall, LCDC II
• Keith Allen Hamilton
• Goble Oneal Hammonds
• Jeremy Hanson, CDCA
• James Harding
• Jessica Rose Hoffer
• Brooke James, CDCA

• Addiction (Substance Use Disorder) Counselor in McDermott, OH
• Providers in McDermott, 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 Oct 13, 2023; 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.