Individual provider Active NPI

Jessica L Racine, LPC

  • Counselor
  • Allentown, PA
National Provider Identifier
1508509878
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
PC007262 Issued in PA
Practice address
1259 S Cedar Crest Blvd Ste 230
Allentown, PA 18103-6376
Phone
(610) 402-5900
Fax
(610) 402-4650
NPI assigned
Apr 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X PC007262 PA Primary

Addresses

Primary practice location

1259 S Cedar Crest Blvd Ste 230
Allentown, PA 18103-6376

Mailing address

1605 N Cedar Crest Blvd Ste 411
Allentown, PA 18104-2323
Phone (484) 884-0688

Other identifiers 1

IdentifierTypeStateIssuer
PC007262OtherPASTATE LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240516000708 PA Practitioner - Mental Health Counselor 8022459494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1259 S Cedar Crest Blvd
230 LVPG Adult and Pediatric Psychiatry
Allentown, PA 18103-6376
Phone (610) 402-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC007262PAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Apr 9, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Apr 9, 2024 Accepting new patients

Locations

1259 S Cedar Crest Blvd
Ste 230
Allentown, PA 18103
Phone (610) 402-5900

2100 Mack Blvd
Fl 4
Allentown, PA 18103

Organizations & group practices 4

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": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1508509878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 N CEDAR CREST BLVD STE 411",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042323",
            "telephone_number": "484-884-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 S CEDAR CREST BLVD STE 230",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036376",
            "telephone_number": "610-402-5900",
            "fax_number": "610-402-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACINE",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "PA",
            "license": "PC007262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PC007262",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.