Active NPI
Jessica Lynn Klotz
- Professional Counselor
- Easton, MD
National Provider Identifier
1699323774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC10393
- Practice address
- 111 N West St Ste H
Easton, MD 21601-2760 - Phone
- (410) 449-0025
- NPI assigned
- Aug 31, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC10393 | MD | Primary |
| Art Therapist | 221700000X | ATC169 | MD |
Addresses
Primary practice location
111 N West St Ste H
Easton, MD 21601-2760
Mailing address
28931 Sanderstown Rd
Trappe, MD 21673-1956
Phone (717) 659-0233
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC10393 | MD | MD | Professional Counselor |
| ATC169 | MD | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586736000000",
"number": "1699323774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28931 SANDERSTOWN RD",
"city": "TRAPPE",
"state": "MD",
"postal_code": "216731956",
"telephone_number": "717-659-0233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 N WEST ST STE H",
"city": "EASTON",
"state": "MD",
"postal_code": "216012760",
"telephone_number": "410-449-0025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLOTZ",
"first_name": "JESSICA",
"middle_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-31",
"last_updated": "2020-04-13",
"certification_date": "2020-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC10393",
"primary": true
},
{
"code": "221700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Art Therapist",
"state": "MD",
"license": "ATC169",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Easton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.