Jessica C Prutsman

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC016293 Issued in PA

Practice address

103 Forestview Ave
Elkland, PA 16920-1403

Phone

(814) 258-5117

NPI assigned

Apr 20, 2021

Last updated

Jan 17, 2024By the provider in NPPES

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 names 1

• Miss Jessica C Carr Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Penn Comprehensive Health Services

  dba Laurel Health Center

  • Federally Qualified Health Center (FQHC)
  • Wellsboro, PA
  • NPI 1912093576
  Medicare reassignment NPD
• North Penn Comprehensive Health Services

  dba Sullivan County Laurel Health Center

  • Federally Qualified Health Center (FQHC)
  • Laporte, PA
  • NPI 1093520587
  NPD
• North Penn Comprehensive Health Services

  dba Laurel Health & Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Mansfield, PA
  • NPI 1609433036
  NPD
• North Penn Comprehensive Health Services

  dba Elkland Laurel Health Center

  • Federally Qualified Health Center (FQHC)
  • Elkland, PA
  • NPI 1003913955
  NPD (past)
• North Penn Comprehensive Health Services

  dba Blossburg Laurel Health Center

  • Federally Qualified Health Center (FQHC)
  • Blossburg, PA
  • NPI 1154403038
  NPD (past)
• North Penn Comprehensive Health Services

  dba Wellsboro Laurel Health Center

  • Federally Qualified Health Center (FQHC)
  • Wellsboro, PA
  • NPI 1235570417
  NPD (past)
• North Penn Comprehensive Health Services

  dba Lawrenceville Laurel Health Center

  • Federally Qualified Health Center (FQHC)
  • Lawrenceville, PA
  • NPI 1326148164
  NPD (past)
• North Penn Comprehensive Health Services

  • Federally Qualified Health Center (FQHC)
  • Troy, PA
  • NPI 1417536285
  NPD (past)
• North Penn Comprehensive Health Services

  dba Mansfield Laurel Health Center

  • Federally Qualified Health Center (FQHC)
  • Mansfield, PA
  • NPI 1750461455
  NPD (past)

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1811578917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W WELLSBORO ST",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "169331411",
            "telephone_number": "570-662-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 FORESTVIEW AVE",
            "city": "ELKLAND",
            "state": "PA",
            "postal_code": "169201403",
            "telephone_number": "814-258-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUTSMAN",
        "first_name": "JESSICA",
        "middle_name": "C",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC016293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "CARR",
            "middle_name": "C",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew P Heckman, MD, PHD
• North Penn Comprehensive Health Services (Elkland Laurel Health Center)
• Northern Tioga School District
• Novapharm Enterprises Inc. (Buchanan Brothers Pharmacy)
• Scott L Pawlak, D.D.S.
• Andrei Rudic, D.M.D.
• Todd A Rudy, PA-C
• Brittany Seeley, DC
• Strohecker Vision Care, Inc
• Joseph Alexander White, PA-C

• Professional Counselor in Elkland, PA
• Providers in Elkland, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.