Jennie Statczar, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C.2002647 Issued in OH

Practice address

1170 Old Henderson Rd Ste 100
Columbus, OH 43220-3623

Phone

(614) 442-7650

NPI assigned

Jul 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Spirit of Peace Clinical Counseling

  • Mental Health Counselor
  • Columbus, OH
  • NPI 1982834974

  Professional

  NPD (past)

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1457903270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 OLD HENDERSON RD STE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432203623",
            "telephone_number": "614-442-7650",
            "fax_number": "614-442-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 OLD HENDERSON RD STE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432203623",
            "telephone_number": "614-442-7650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 E Main St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432155369",
            "country_code": "US",
            "telephone_number": "614-355-6340",
            "fax_number": "614-355-6347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STATCZAR",
        "first_name": "JENNIE",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "C.1801397-TRNE",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2002647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1473276",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sydney Starr
• Tammy Lou Starr
• Jerome E Stasek, MD
• Nancy Lee Stasik, PA-C
• Alisyn Staskiewicz
• State of Ohio Budget and Management State Accounting
• State of Ohio Office of Budget & Management State Accounting
• State of Ohio Office of Budget & Management State Accounting
• State of Ohio Office of Budget and Management
• State of Ohio Office of Budget and Management State Accounting

• Professional Counselor in Columbus, OH
• Providers in Columbus, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.