Jessica Lynn Block, MA, NCC, LPCA, LCASA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A13591 Issued in NC

Practice address

1135 Kildaire Farm Rd Ste 303
Cary, NC 27511-4587

Phone

(919) 678-3817

Fax

(919) 747-4257

NPI assigned

Jun 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jessica Lynn Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Foundations Family Therapy of North Carolina, PLLC

  • Community/Behavioral Health Agency
  • Fuquay Varina, NC
  • NPI 1366793895
  NPD (past)

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1750875845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6905 RIVER RUN APT 26",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276132209",
            "telephone_number": "919-271-2013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 KILDAIRE FARM RD STE 303",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114587",
            "telephone_number": "919-678-3817",
            "fax_number": "919-747-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCK",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "MA, NCC, LPCA, LCASA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "830000",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "23992",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A13591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SMITH",
            "middle_name": "LYNN",
            "credential": "MA, NCC, LPCA, LCASA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sharon Blinson, M.S.CCC-SLP
• Christine M. Bliss, OTR
• Danielle Marie Bliss, M.D., M.B.A.
• Stacie Bliss, LPC
• Blizzard Health Services (Assurance Health Services)
• Carie L Bloom, MD
• O Josh Bloom, MD
• Blooming Medical Group, PLLC
• Valerie Blouin-Hunter
• James Gordon Blount, MD

• Mental Health Counselor in Cary, NC
• Providers in Cary, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.