Jacqueline Haskins

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.1901558 Issued in OH

Practice address

975 Commerce Dr
Perrysburg, OH 43551-5228

Phone

(419) 874-8257

NPI assigned

Feb 24, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fort Meigs Wellness and Behavioral Health LLCGroup PAC ID 3375983919, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Fort Meigs Wellness & Behavioral Health LLC

  • Mental Health Counselor
  • Perrysburg, OH
  • NPI 1679323547
  Medicare reassignment Care Compare group NPD
• Fort Meigs Psychological Service

  • Psychologist
  • Perrysburg, OH
  • NPI 1649337817

  Single Specialty

  NPD

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1841999208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 COMMERCE DR",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515228",
            "telephone_number": "419-874-8257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 COMMERCE DR",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515228",
            "telephone_number": "419-874-8257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASKINS",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-24",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.1901558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "341732773",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Lynn Harmon-Rodriguez, LPCC-S
• Harness Health Pharmacy - Ohio LLC (Harness Health Pharmacy #123)
• Heather Lynn Harris, RD, LD
• Taeler Harris
• Jessica Hartman, FNP-C
• Mohamad Hazem Hatahet, MD
• Stefani Hathaway, PHD
• Haydar Healthcare
• Cecily Elaine Hayward
• HCF of Perrysburg, Inc. (The Manor at Perrysburg Lab)

• Mental Health Counselor in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.