Active NPI
Jennifer Beall, M.S., NCC, LCPC
- Pastoral Counselor
- Crofton, MD
National Provider Identifier
1578733606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- LC2732
- Practice address
- 1457 Jordan Ave
Crofton, MD 21114-2119 - Phone
- (240) 401-8086
- NPI assigned
- Mar 4, 2008
- Last updated
- Jan 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | LC2732 | MD | Primary |
Addresses
Primary practice location
1457 Jordan Ave
Crofton, MD 21114-2119
Mailing address
1457 Jordan Ave
Crofton, MD 21114-2119
Phone (240) 401-8086
Other names 1
- Jennifer Riley
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 7, 2024 through Feb 7, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC2732 | MD | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578355200000",
"number": "1578733606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1457 JORDAN AVE",
"city": "CROFTON",
"state": "MD",
"postal_code": "211142119",
"telephone_number": "240-401-8086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1457 JORDAN AVE",
"city": "CROFTON",
"state": "MD",
"postal_code": "211142119",
"telephone_number": "240-401-8086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEALL",
"first_name": "JENNIFER",
"credential": "M.S., NCC, LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-04",
"last_updated": "2020-01-07",
"certification_date": "2020-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "MD",
"license": "LC2732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "RILEY",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Crofton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.