Annette M Jongsma, MS, LPCA

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6447 Issued in CT

Practice address

1120 Laurel Ave
Bridgeport, CT 06604-2148

Phone

(203) 209-6913

NPI assigned

Jun 16, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South-West Community Health Center IncGroup PAC ID 2466445200, 52 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ajongsma779529@direct.ochin.org

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.

• South-West Community Health Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bridgeport, CT
  • NPI 1699703686
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1686873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1831874916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 LAUREL AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066042148",
            "telephone_number": "203-209-6913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 LAUREL AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066042148",
            "telephone_number": "203-209-6913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONGSMA",
        "first_name": "ANNETTE",
        "middle_name": "M",
        "credential": "MS, LPCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-16",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CT",
            "license": "6447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiyaira Jones-Gilchrist
• Genise Jones
• Maureen Veronica Jones, APRN
• Wanda R a Jones, LCSW
• Wendy Jones, LPC
• Andre Ryan Jordan, MD, PHD
• Audray Joseph, RN
• Christina Joseph, CRNA
• Cynthia Joseph, CRNA
• Kristina Josephson, OTR/L

• Counselor in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.