Jessica Gardner Bennett

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

17 Hospital Drive
Bushnell Medica
Massena, NY 13662

Phone

(315) 705-6564

Fax

(315) 705-6567

NPI assigned

Mar 23, 2022

Last updated

Mar 23, 2022By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1639828882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 HOSPITAL DRIVE",
            "address_2": "BUSHNELL MEDICA",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "13662",
            "telephone_number": "315-705-6564",
            "fax_number": "315-705-6567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 HOSPITAL DRIVE",
            "address_2": "BUSHNELL MEDICA",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "13662",
            "telephone_number": "315-705-6564",
            "fax_number": "315-705-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER BENNETT",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbennett@stjoestreatment.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "17 Hospital Drive",
            "address_2": "Bushnell Medica",
            "city": "Massena",
            "state": "NY",
            "country_code": "US",
            "postal_code": "13662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua L Frank, M.D.
• Eileen Mary Fregoe, PT
• Jacenta Michelle Fregoe, LPN
• Samantha Marie Frohm, BCBA, LBA
• Veronica Fuller, PT/DPT
• Gary Torbey DO PLLC (Seaway Valley Eyecare)
• Peggy Elizabeth Gibson, REGISTERED NURSE
• Laura Marie Goldhar, PA
• Alexis Nicole Gondosch
• Jacob A Goyco

• Addiction (Substance Use Disorder) Counselor in Massena, NY
• Providers in Massena, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.