Jason Matthew Kirk, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC009646 Issued in PA

Practice address

1120 W Township Line Rd Ste 101
Havertown, PA 19083-4930

Phone

(610) 708-0721

Fax

(267) 285-1994

NPI assigned

Jun 15, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Dtap Mental Health Services LLC

  • Mental Health Counselor
  • Havertown, PA
  • NPI 1518737824
  Medicare reassignment NPD

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1720518327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W TOWNSHIP LINE RD STE 101",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190834930",
            "telephone_number": "610-708-0721",
            "fax_number": "267-285-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W TOWNSHIP LINE RD STE 101",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190834930",
            "telephone_number": "610-708-0721",
            "fax_number": "267-285-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "JASON",
        "middle_name": "MATTHEW",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-15",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC009646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kind Heart Home Healthcare LLC
• Andrew Jay Kind-Rubin
• Kindred Hospitals East, LLC
• Kindred Hospitals East, LLC
• Alexis King
• Sabrina Kirk, LPC
• Tyhesha Kirkland
• Florence Kirsch
• Thomas E Klein, M.D
• Marci J. Kliger, ATC

• Professional Counselor in Havertown, PA
• Providers in Havertown, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.