Jessena Samuel Varghese

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

9929 Birkenhead CT
Yukon, OK 73099-7945

Phone

(718) 235-3100

NPI assigned

May 5, 2015

Last updated

Jan 13, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jessena Johnykutty Samuel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515801600000",
    "number": "1912384363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9929 BIRKENHEAD CT",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730997945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9929 BIRKENHEAD CT",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730997945",
            "telephone_number": "718-235-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "JESSENA",
        "middle_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-05",
        "last_updated": "2018-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSENA",
            "last_name": "SAMUEL",
            "middle_name": "JOHNYKUTTY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jordan Vanderbilt
• Micah Vandine
• Joni Vanmeter
• Debra Vanwieren
• Sheeba Varghese Mathai, RPH
• Variety Care, Inc.
• Variety Care, Inc. (Variety Care Yukon)
• Jacob Vaughan
• Anembom Mineku Vegah
• Shanice Velez-Patron

• Professional Counselor in Yukon, OK
• Providers in Yukon, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2018; 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.