Jessica Katharine Blose, LMHC
Individual provider Active NPI Mental Health Counselor · Niagara Falls, NY
NPI 1750705331 · NPPES record last updated Feb 18, 2014
Key facts
- NPI
- 1750705331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 005930-1 (NY)
- Practice address
- 1001 11TH St
Niagara Falls, NY 14301-1201 - Phone
- (716) 278-8110
- Fax
- (716) 278-8111
- NPI assigned
- Feb 18, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005930-1 | NY | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 005930-1 | NY | |
| Mental Health Counselor | 101YM0800X | 005930-1 | NY | Yes |
Addresses
Primary practice location
1001 11TH St
Niagara Falls, NY 14301-1201
Mailing address
1001 11TH St
Niagara Falls, NY 14301-1201
Phone (716) 278-8110
Other providers in Niagara Falls, NY
- Brenda J Blackchief-Macholz
- Adreona Blackmon
- Tiffany Blackmon
- Andrew Blaszak
- Bleich, Inc.
- David Allen Bluett
- John Patrick Blundell
- Lorene Ann Bocchicchia
- Raymond Bogart
- Ryan G Boggs
All providers in Niagara Falls, NY · Mental Health Counselor in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.