Individual provider Active NPI

Jessica Denise Thomas, LPC, NCC, CTTS

  • Professional Counselor
  • Jackson, MS
National Provider Identifier
1477918043
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2020 Issued in MS
Practice address
1138 Pecan Blvd
Jackson, MS 39209-7146
Phone
(601) 503-6817
NPI assigned
Dec 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 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 2020 MS Primary

Addresses

Primary practice location

1138 Pecan Blvd
Jackson, MS 39209-7146

Mailing address

1138 Pecan Blvd
Jackson, MS 39209-7146
Phone (601) 503-6817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20241111002009 MS Practitioner - Mental Health Counselor 5597299776 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Sep 3, 2024 Accepting new patients
Jade Clinical Supervision and Consultation, LLC Professional Current Accepting new patients
State of Mississippi-University of Mississippi Medical Center CurrentSince Sep 3, 2024 Accepting new patients
Your New Beginning Counseling Services, LLC CurrentSince Sep 20, 2020 Accepting new patients

Locations

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

Organizations & group practices 5

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": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1477918043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 PECAN BLVD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392097146",
            "telephone_number": "601-503-6817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 PECAN BLVD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392097146",
            "telephone_number": "601-503-6817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JESSICA",
        "middle_name": "DENISE",
        "name_prefix": "Miss",
        "credential": "LPC, NCC, CTTS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "2020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.