Jalissa Ann Jerry

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1211 Harrington St
Beaufort, SC 29902

Phone

(843) 524-8899

NPI assigned

Aug 3, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• South Carolina Dept of Mental Health Accounting Office

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD (past)

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1548784267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025400",
            "telephone_number": "843-524-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 HARRINGTON ST",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "29902",
            "telephone_number": "843-524-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERRY",
        "first_name": "JALISSA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "576000922",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian W Jansen, MD
• Roseella Jeanbaptiste
• Dennis Sherwood Jenkins, RPH
• Shavon Jenkins
• Jennifer Renee Cazales
• Raymond Ellsworth Jimison II, O.D.
• Ferine N. Johannes, O.D.
• Sara Johannesmeyer, D.M.D.
• Lashawn Johnson Cromwell
• Colin Mitchell Johnson, MD

• Mental Health Counselor in Beaufort, SC
• Providers in Beaufort, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.