Jeremiah Richard D'Allesandro, CAC-AD

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

AC1894 Issued in MD

Practice address

103 Williamsport Cir Unit a
Salisbury, MD 21804-6472

Phone

(443) 513-0500

NPI assigned

Jun 30, 2021

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Revision Wellness, LLC

  • Clinic/Center
  • Berlin, MD
  • NPI 1497390702
  NPD (past)

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1851961858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11003 GRAYS CORNER RD UNIT 71",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113557",
            "telephone_number": "443-210-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 WILLIAMSPORT CIR UNIT A",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046472",
            "telephone_number": "443-513-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ALLESANDRO",
        "first_name": "JEREMIAH",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "CAC-AD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "AC1894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Addiction (Substance Use Disorder) Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.