Active NPI
Jackie M Rider
- Professional Counselor
- Greensburg, PA
National Provider Identifier
1891374419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC001495
- Practice address
- 4963 US 30
Suite 204
Greensburg, PA 15601 - Phone
- (724) 610-7724
- NPI assigned
- Apr 2, 2021
- Last updated
- Apr 2, 2021
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC001495 | PA | Primary |
Addresses
Primary practice location
4963 US 30
Suite 204
Greensburg, PA 15601
Mailing address
4963 US 30
Suite 204
Greensburg, PA 15601
Phone (724) 610-7724
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC001495 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617321600000",
"number": "1891374419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4963 US 30",
"address_2": "SUITE 204",
"city": "GREENSBURG",
"state": "PA",
"postal_code": "15601",
"telephone_number": "724-610-7724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4963 US 30",
"address_2": "SUITE 204",
"city": "GREENSBURG",
"state": "PA",
"postal_code": "15601",
"telephone_number": "724-610-7724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDER",
"first_name": "JACKIE",
"middle_name": "M",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-02",
"last_updated": "2021-04-02",
"certification_date": "2021-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC001495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensburg, PA
- Kennedy Rhodes
- David Rice, M.D.
- Richard Hoffman (Christian Counseling Associates of Eastern Ohio)
- Richard Hoffman (Christian Counseling Associates of Western PA)
- Brandon Michael Ricker, MS, NCC, LPC
- Hiedi Elizabeth Ridgway
- Kimberly Sue Ridilla, RPH
- John Charles Ridinger, DMD
- Deborah Rietski, NCC, LPC
- Christina D Rife, MA, NCC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.