Individual provider Active NPI

Gabriela Jump, LPC

  • Professional Counselor
  • Madison, WI
National Provider Identifier
1821640335
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4334-226 Issued in WI
Practice address
811 E Washington Ave Ste 400
Madison, WI 53703-4028
Phone
(608) 389-0253
NPI assigned
Jul 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 18679-130 WI
Professional Counselor 101YP2500X 4334-226 WI Primary

Addresses

Primary practice location

811 E Washington Ave Ste 400
Madison, WI 53703-4028

Mailing address

811 E Washington Ave Ste 400
Madison, WI 53703-4028
Phone (608) 389-0253

Other identifiers 1

IdentifierTypeStateIssuer
4334-226MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18679-130WIMDAddiction (Substance Use Disorder) Counselor
4334-226WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Simplicity in Authenticity Counseling, LLC Professional Current Accepting new patients

Locations

811 E Washington Ave
Ste 400
Madison, WI 53703
Phone (425) 522-2853

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1821640335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 E WASHINGTON AVE STE 400",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537034028",
            "telephone_number": "608-389-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E WASHINGTON AVE STE 400",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537034028",
            "telephone_number": "608-389-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUMP",
        "first_name": "GABRIELA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "18679-130",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4334-226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4334-226",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.