Jessica Ahern, LPC
Individual provider Active NPI Professional Counselor · Middletown, CT
NPI 1942986393 · NPPES record last updated Nov 24, 2023
Key facts
- NPI
- 1942986393
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 46.006490 (CT)
- Practice address
- 675 Main St
Middletown, CT 06457-2732 - Phone
- (860) 347-6971
- Fax
- (860) 638-6831
- NPI assigned
- Jun 22, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 17
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Health Center Inc
Practice addresses (Care Compare)
134 State St
Meriden, CT 06450-3293
Phone (203) 237-2229
19 Grand St
Middletown, CT 06457-2705
675 Main St
Middletown, CT 06457-2732
Phone (860) 347-6971
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240122002913 | CT | Practitioner - Mental Health Counselor | 6608224472 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46.006490 | CT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peaceful Mind Behavioral Health & Wellness, LLC | Professional | Current |
Accepting new patients |
| Peaceful Mind Behavioral Health & Wellness, LLC | Professional | Current |
Accepting new patients |
| Community Health Center Inc | Current |
Accepting new patients | |
| Community Health Center Inc | Current |
Accepting new patients |
Locations
123 Middle St
Bristol, CT 06010
Phone (860) 281-2280
19 Grand St
Middletown, CT 06457
Phone (860) 323-0172
Interoperability endpoints
- jessica.ahern@chcict.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 46.006490 | CT | Yes |
Addresses
Primary practice location
675 Main St
Middletown, CT 06457-2732
Mailing address
123 Middle St
Bristol, CT 06010-7404
Other practice location 1
12 Robin Rd Apt 304
West Hartford, CT 06119-1227
Phone (203) 444-8694
Other practice location 2
123 Middle St
Bristol, CT 06010-7404
Phone (860) 281-2280
Other providers in Middletown, CT
- Advanced Behavioral Health, Inc.
- Advanced Dental PLLC
- Advanced Telepsych PLLC
- Faustina Serwah Agyapong
- George Agyapong
- Tina Marie Ahlquist
- Aidaly Care Connecticut LLC
- Keshava H Aithal
- Mohammed Al-Damluji
- Joshua N Alderman
All providers in Middletown, CT · Professional Counselor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.