Individual provider Active NPI

Jessica Marcello, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gilford, NH
National Provider Identifier
1689283947
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
113680-23 Issued in NH
Practice address
36 Country Club Rd Unit 926H
Gilford, NH 03249-6978
Phone
(609) 393-3233
NPI assigned
Jul 23, 2020
Last updated
Mar 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 202213702NP-PP OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61185664 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 113680-23 NH Primary
Registered Nurse 163W00000X 9276527 FL

Addresses

Primary practice location

36 Country Club Rd Unit 926H
Gilford, NH 03249-6978

Mailing address

36 Country Club Rd Unit 926H
Gilford, NH 03249-6978
Phone (609) 393-3233

Other practice location 1

15640 NE Fourth Plain Blvd Ste 106
#440
Vancouver, WA 98682-5141
Phone (360) 550-9745

Other practice location 2

4212 SE Division St Ste 100
Portland, OR 97206-1680
Phone (503) 238-0705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, NY, NH3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20221006003298 OR Practitioner - Nurse Practitioner 6800272303 Reassigns benefits to 1 organization
I20260611002928 NY Practitioner - Nurse Practitioner 6800272303 Reassigns benefits to 1 organization
I20260612003192 NH Practitioner - Nurse Practitioner 6800272303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCCD Psychiatry Services PLLCGroup PAC ID 4082049036, 206 clinicians

Practice addresses (Care Compare)

109 W 27TH St
5S
New York, NY 10001-6208
Phone (833) 351-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9276527FLMDRegistered Nurse
113680-23NHMDPsychiatric/Mental Health Nurse Practitioner
202213702NP-PPORMDPsychiatric/Mental Health Nurse Practitioner
AP61185664WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sage & Spirit Mental Healthcare, LLC Psychiatric/Mental Health Current Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1689283947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 COUNTRY CLUB RD UNIT 926H",
            "city": "GILFORD",
            "state": "NH",
            "postal_code": "032496978",
            "telephone_number": "609-393-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 COUNTRY CLUB RD UNIT 926H",
            "city": "GILFORD",
            "state": "NH",
            "postal_code": "032496978",
            "telephone_number": "609-393-3233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15640 NE Fourth Plain Blvd Ste 106",
            "address_2": "#440",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986825141",
            "country_code": "US",
            "telephone_number": "360-550-9745",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4212 SE Division St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972061680",
            "country_code": "US",
            "telephone_number": "503-238-0705",
            "fax_number": "503-236-7166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCELLO",
        "first_name": "JESSICA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202213702NP-PP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61185664",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "113680-23",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9276527",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilford, NH

Sources for this page

Verify at the official NPI Registry.