Jessica Dance

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

911 Joyce St Apt 305
Kaukauna, WI 54130-1057

Phone

(920) 389-1585

NPI assigned

Sep 29, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1477277788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 JOYCE ST APT 305",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541301057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 JOYCE ST APT 305",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541301057",
            "telephone_number": "920-389-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANCE",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED SEX ADDICTION COUNSELOR",
            "identifier": "111230",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.pslamsofhealing.info",
            "affiliation": "N",
            "address_1": "911 Joyce St Apt 305",
            "city": "Kaukauna",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541301057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy S Coulthard-Atwater, DO
• Courtney Covill, LPC-IT
• Timothy P Culligan, MD
• Paige Cupp, COTA
• Curtis R. Hebdon, D.D.S., S.C. (Kaukauna Family Dentistry)
• Bruce R Danz, MD
• Emily Ann Dary, CRNA
• Phabian Treyvonne Dejean
• Gregory James Dejong, LAT
• Patricia M Demery, MD

• Counselor in Kaukauna, WI
• Providers in Kaukauna, WI by specialty
• Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.