Active NPI
Jennifer Jacyszyn, MA
- Mental Health Counselor
- Seattle, WA
National Provider Identifier
1831565480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC60505089
- Practice address
- 2208 NW Market St
Suite 407a
Seattle, WA 98107-4030 - Phone
- (206) 607-9141
- NPI assigned
- Aug 18, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC60505089 | WA | Primary |
Addresses
Primary practice location
2208 NW Market St
Suite 407a
Seattle, WA 98107-4030
Mailing address
2208 NW Market St
Suite 407a
Seattle, WA 98107-4030
Phone (206) 607-9141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC60505089 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450656000000",
"number": "1831565480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2208 NW MARKET ST",
"address_2": "SUITE 407A",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981074030",
"telephone_number": "206-607-9141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2208 NW MARKET ST",
"address_2": "SUITE 407A",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981074030",
"telephone_number": "206-607-9141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACYSZYN",
"first_name": "JENNIFER",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-18",
"last_updated": "2015-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC60505089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.