Individual provider Active NPI

Jessica Haurin

  • Professional Counselor
  • Glassboro, NJ
National Provider Identifier
1457732646
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
42 Delsea Dr S
Glassboro, NJ 08028-2621
Phone
(856) 863-0006
NPI assigned
Jun 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NJ Primary

Addresses

Primary practice location

42 Delsea Dr S
Glassboro, NJ 08028-2621

Mailing address

42 Delsea Dr S
Glassboro, NJ 08028-2621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240619000096 NJ Practitioner - Mental Health Counselor 3870036874 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Acenda, Inc. CurrentSince Apr 15, 2024 Accepting new patients

Locations

42 Delsea Dr S
Glassboro, NJ 08028
Phone (856) 863-0006

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1457732646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 DELSEA DR S",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080282621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 DELSEA DR S",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080282621",
            "telephone_number": "856-863-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAURIN",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glassboro, NJ

Sources for this page

Verify at the official NPI Registry.