Individual provider Active NPI

Jessica Johannah Creekmore, LGPC

  • Mental Health Counselor
  • Annapolis, MD
National Provider Identifier
1528881141
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LGP15790 Issued in MD
Practice address
900 Bestgate Rd Ste 210
Annapolis, MD 21401-7922
Phone
(410) 267-3706
NPI assigned
Nov 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LGP15790 MD Primary

Addresses

Primary practice location

900 Bestgate Rd Ste 210
Annapolis, MD 21401-7922

Mailing address

900 Bestgate Rd Ste 210
Annapolis, MD 21401-7922
Phone (410) 267-3706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LGP15790MDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1528881141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 BESTGATE RD STE 210",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017922",
            "telephone_number": "410-267-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 BESTGATE RD STE 210",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017922",
            "telephone_number": "410-267-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEKMORE",
        "first_name": "JESSICA",
        "middle_name": "JOHANNAH",
        "credential": "LGPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP15790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.