Jenica Ellen Rea, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4242 Issued in AL

Practice address

508 Crackwillow Ave
Fairhope, AL 36532-0028

Phone

(251) 979-2242

NPI assigned

Feb 2, 2016

Last updated

Jan 19, 2021By the provider in NPPES

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 DC, DE, WI3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC, DE, WI

  Medicare reassignment NPD
• Changes Counseling & Consultation, LLC

  • Clinical Social Worker
  • Sandy, UT
  • NPI 1457482242

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1871951095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 CRACKWILLOW AVE",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365320028",
            "telephone_number": "251-979-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 CRACKWILLOW AVE",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365320028",
            "telephone_number": "251-979-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REA",
        "first_name": "JENICA",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-02",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "4242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13876117",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl Lynn Ramirez, M.A. CCC-SLP
• Richard David Rammel, PT
• Randall L. Hall, M.D., P.C.
• Kate G Rawson, M.S.
• Laura Susan Ray, MD
• Reach Kidney Care LLC (Fairhope REACH CKD Clinic)
• J. Gregory Reasons, OD
• Chad David Reaves, DO
• Rajadhar Reddy, MD
• Patricia Reed, PMHNP-BC

• Professional Counselor in Fairhope, AL
• Providers in Fairhope, AL by specialty
• Professional Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.