Jaclyn M Gleason, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

171643 Issued in KY

Practice address

200 Home Rd
Covington, KY 41011-1942

Phone

(859) 261-8768

Fax

(859) 291-2431

NPI assigned

Feb 20, 2017

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

Other names 1

• Jaclyn M Zembrodt Former name

Medicare fee-for-service enrollment

Enrolled in KY

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.

Enrollment records 1

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.

• Children's Home of Northern Kentucky

  dba OneQuest Health Outpatient

  • Community/Behavioral Health Agency
  • Covington, KY
  • NPI 1386979615
  Medicare reassignment NPD
• Children's Home of Northern Kentucky

  dba OneQuest Health Residential

  • Psychiatric Residential Treatment Facility
  • Covington, KY
  • NPI 1467934315
  NPD (past)

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1811436165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOME RD",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410111942",
            "telephone_number": "859-261-8768",
            "fax_number": "859-291-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOME RD",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410111942",
            "telephone_number": "859-261-8768",
            "fax_number": "859-291-2431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "JACLYN",
        "middle_name": "M",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-20",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "171643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100447160",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "ZEMBRODT",
            "middle_name": "M",
            "credential": "LPCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather Gerak, B.A.
• Cora Gifford, PMHNP
• Christy Lynn Gillespie, LCSW
• Kayla Gillespie
• Suzanne L Glasenapp
• Andrew Michael Glockner, LCSW
• Elizabeth Goodan, MSN, APRN, AGPCNP-BC
• William A Goodpaster III
• Nathan Allan Gordon, MD
• Victoria Marie Gottfried, LCSW, LISW, PHD

• Professional Counselor in Covington, KY
• Providers in Covington, KY by specialty
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.