Jessica Pescatore, LAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37AC00513100 Issued in NJ

Practice address

305 Independence Blvd
Sicklerville, NJ 08081-1093

Phone

(609) 365-0712

Fax

(609) 904-2265

NPI assigned

Oct 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Beautiful Minds, Therapy and Consultation

  • Mental Health Counselor
  • Sicklerville, NJ
  • NPI 1770340564
  NPD

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

{
    "created_epoch": "1635465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1760146203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 INDEPENDENCE BLVD",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080811093",
            "telephone_number": "609-365-0712",
            "fax_number": "609-904-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 INDEPENDENCE BLVD",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080811093",
            "telephone_number": "609-365-0712",
            "fax_number": "609-904-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESCATORE",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-29",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37AC00513100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0506290",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanya Pearson
• Carmen Peralta
• Maria Perez
• Wanda Perez
• Kylah Perry
• Joshua Phillips
• Stephen Michael Phillips, R.PH.
• Melvin Keith Pierson, D.D.S.
• Natalie Williams Pierson, RN
• Nicol Pilic, PHARM D

• Professional Counselor in Sicklerville, NJ
• Providers in Sicklerville, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.