Active NPI
Jillian Denise Mishko
- Professional Counselor
- Clarks Summit, PA
National Provider Identifier
1922644368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC011518
- Practice address
- 411 Davis St
Clarks Summit, PA 18411-1837 - Phone
- (570) 575-9086
- NPI assigned
- Nov 20, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | PC011518 | PA | Primary |
Addresses
Primary practice location
411 Davis St
Clarks Summit, PA 18411-1837
Mailing address
411 Davis St
Clarks Summit, PA 18411-1837
Phone (570) 575-3765
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 |
|---|---|---|---|
| PC011518 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574208000000",
"number": "1922644368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 DAVIS ST",
"city": "CLARKS SUMMIT",
"state": "PA",
"postal_code": "184111837",
"telephone_number": "570-575-3765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 DAVIS ST",
"city": "CLARKS SUMMIT",
"state": "PA",
"postal_code": "184111837",
"telephone_number": "570-575-9086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISHKO",
"first_name": "JILLIAN",
"middle_name": "DENISE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-20",
"last_updated": "2019-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC011518",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarks Summit, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.