Individual provider Active NPI

Jessica Radcliff, LPC

  • Professional Counselor
  • Hartford, CT
National Provider Identifier
1811326002
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
331 Wethersfield Ave
Hartford, CT 06114-1438
Phone
(860) 236-4511
NPI assigned
Nov 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

331 Wethersfield Ave
Hartford, CT 06114-1438

Mailing address

331 Wethersfield Avenue
Hartford, CT 06114-1420

Other practice location 1

17 S Highland St
West Hartford, CT 06119-1826
Phone (860) 258-4171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240104004175 CT Practitioner - Mental Health Counselor 2466803309 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reflections LLCGroup PAC ID 0941669139, 12 clinicians
The Village for Families and Children IncGroup PAC ID 3072579895, 16 clinicians

Practice addresses (Care Compare)

17 S Highland St
West Hartford, CT 06119-1826
Phone (860) 258-4171

331 Wethersfield Ave
Hartford, CT 06114-1420
Phone (860) 236-4511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5240CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
The Village for Families & Children, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Reflections LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

331 Wethersfield Ave
Hartford, CT 06114
Phone (860) 236-4511

1680 Albany Ave
Hartford, CT 06105
Phone (860) 236-4511

331 Wethersfield Ave
Ste 2
Hartford, CT 06114
Phone (860) 236-4511

17 S Highland St
West Hartford, CT 06119
Phone (860) 236-6009

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1811326002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 WETHERSFIELD AVENUE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061141420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 WETHERSFIELD AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061141438",
            "telephone_number": "860-236-4511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 S Highland St",
            "address_purpose": "LOCATION",
            "city": "West Hartford",
            "state": "CT",
            "postal_code": "061191826",
            "country_code": "US",
            "telephone_number": "860-258-4171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADCLIFF",
        "first_name": "JESSICA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.