Jenna Staub, LCSW-A, LCAS-A

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

29080 Issued in NC

Practice address

503 Covil Ave Ste 102
Wilmington, NC 28403-2683

Phone

(910) 995-4154

NPI assigned

Dec 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Clinical Social Worker

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rha Health Services IncGroup PAC ID 8426196072, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Rha Health Services Inc

  • Community/Behavioral Health Agency
  • Concord, NC
  • NPI 1447376306
  Medicare reassignment Care Compare group
• Rha Behavioral Health NC LLC

  • Community/Behavioral Health Agency
  • Whiteville, NC
  • NPI 1700318680
  Medicare reassignment

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712966400000",
    "number": "1629673835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 FAYETTEVILLE ST STE 1100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276013000",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 COVIL AVE STE 102",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032683",
            "telephone_number": "910-995-4154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "421 Fayetteville St Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276013000",
            "country_code": "US",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAUB",
        "first_name": "JENNA",
        "credential": "LCSW-A, LCAS-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2024-04-13",
        "certification_date": "2024-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "29080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Stark
• Kameron Marie Starling, RBT
• Paul Britt Starling, MD
• Jacquelyn Starosciak
• Jennifer L. Starrett, ARNP
• Jonathan Simon Staub, M.D.
• Svetlana Alexandra Staub, MD
• Lynn Stavely
• Michele Deeley Stavovy, PA-C
• Bryanna Elizabeth Stearns, CRNA

• Addiction (Substance Use Disorder) Counselor in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.