Individual provider Active NPI

Jacquelyn E Nasby, PROF COUNS IN TRAINI

  • Mental Health Counselor
  • Milwaukee, WI
National Provider Identifier
1760911945
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2926-226 Issued in WI
Practice address
7330 W Layton Ave
Milwaukee, WI 53220
Phone
(414) 817-8896
Fax
(414) 817-8940
NPI assigned
Jun 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2926-226 WI Primary

Addresses

Primary practice location

7330 W Layton Ave
Milwaukee, WI 53220

Mailing address

7330 W Layton Ave
Milwaukee, WI 53220-3849
Phone (414) 817-8896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20240409001074 WI Practitioner - Clinical Social Worker 4587002621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Behavioral Clinics SCGroup PAC ID 7517937964, 46 clinicians

Practice addresses (Care Compare)

7330 W Layton Ave
Milwaukee, WI 53220-3849
Phone (414) 281-1677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2926-226WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
American Behavioral Clinics, SC CurrentSince Mar 8, 2024 Accepting new patients

Locations

7330 W Layton Ave
Milwaukee, WI 53220
Phone (414) 281-1677

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1760911945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7330 W LAYTON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532203849",
            "telephone_number": "414-817-8896",
            "fax_number": "414-817-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 W LAYTON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53220",
            "telephone_number": "414-817-8896",
            "fax_number": "414-817-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASBY",
        "first_name": "JACQUELYN",
        "middle_name": "E",
        "credential": "PROF COUNS IN TRAINI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "2926-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.