Jessica Fetchick

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC016876 Issued in PA

Practice address

340 Montage Mountain Rd
Moosic, PA 18507-1707

Phone

(570) 346-3686

Fax

(570) 558-6838

NPI assigned

Mar 21, 2024

Last updated

Mar 21, 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

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Matthew a Berger MD PCGroup PAC ID 5991791212, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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

• Matthew a Berger MD PC

  • Physician Assistant
  • Moosic, PA
  • NPI 1275617508
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1447010889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MONTAGE MOUNTAIN RD # A",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071707",
            "telephone_number": "570-346-3686",
            "fax_number": "570-558-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MONTAGE MOUNTAIN RD",
            "city": "MOOSIC",
            "state": "PA",
            "postal_code": "185071707",
            "telephone_number": "570-346-3686",
            "fax_number": "570-558-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETCHICK",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC016876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Drasba
• Embrace Real Healing, Mental Health Therapy LCC
• Marian Louise Farrell, PHD, APRN, PMH-BC,
• Joseph James Fauzio Jr., LCSW
• Joseph Feistl, PA
• Amanda Lyn Fidiam, PA-C
• Erin Fiske, LCSW
• Jacob Wesley Frazier
• Robert J French Jr., LCSW
• Rachel Galati

• Professional Counselor in Moosic, PA
• Providers in Moosic, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.