Jacqueline Rose Reiss, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904006986 Issued in VA

Practice address

429 N Belvedere Dr
Hampstead, NC 28443-7407

Phone

(757) 409-4008

NPI assigned

Apr 3, 2009

Sex

Female

Sole proprietor

Yes

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 DC, NC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, DC, NC

  Medicare reassignment NPD

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

{
    "created_epoch": "1238716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1730321829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 N BELVEDERE DR",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284437407",
            "telephone_number": "757-409-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 N BELVEDERE DR",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284437407",
            "telephone_number": "757-409-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISS",
        "first_name": "JACQUELINE",
        "middle_name": "ROSE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-03",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raw Functional Nutrition
• Realo Discount Drug Stores of Eastern North Carolina Inc (Realo Discount Drugs)
• Glenda Michelle Reams Mercer, HIS
• Victoria Reed
• Erin Regan, MS, CCC-SLP
• Alexis Ivan Renteria
• Mostafa Mohamed Rezk, DO
• Riccobene & Associates I, DDS, P.a. (Riccobene Associates Family Dentistry - Hampstead)
• Warren Merton Rich, DDS
• Richard H Ferriggi PT Inc

• Clinical Social Worker in Hampstead, NC
• Providers in Hampstead, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.