Individual provider Active NPI

Jessica Fowler

  • Professional Counselor
  • Weirton, WV
National Provider Identifier
1962885335
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2528 Issued in WV
Practice address
3203 Pennsylvania Ave Ste 1
Weirton, WV 26062-3852
Phone
(304) 810-2657
NPI assigned
Jul 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.1700307 OH
Professional Counselor 101YP2500X C.1500446 OH
Professional Counselor 101YP2500X 009079 PA
Professional Counselor 101YP2500X 2528 WV Primary

Addresses

Primary practice location

3203 Pennsylvania Ave Ste 1
Weirton, WV 26062-3852

Mailing address

3203 Pennsylvania Ave Ste 1
Weirton, WV 26062-3852
Phone (304) 810-2657

Other practice location 1

500 Market St Ste 203
Steubenville, OH 43952-2847
Phone (304) 491-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20240201001143 WV Practitioner - Mental Health Counselor 9931552353 Reassigns benefits to 1 organization
I20250909004555 OH Practitioner - Mental Health Counselor 9931552353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Valley CounselingGroup PAC ID 8022461441, 3 clinicians

Practice addresses (Care Compare)

2889 Pennsylvania Ave
Weirton, WV 26062-3718
Phone (304) 491-8200

500 Market St
Suite 203
Steubenville, OH 43952-2847
Phone (304) 491-8200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1500446OHMDProfessional Counselor
E.1700307OHMDProfessional Counselor
009079PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Valley Counseling CurrentSince Jan 1, 2024 Accepting new patients

Locations

3203 Pennsylvania Ave
Ste 1
Weirton, WV 26062
Phone (304) 491-8200

2889 Pennsylvania Ave
Weirton, WV 26062
Phone (304) 491-8200

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1962885335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 PENNSYLVANIA AVE STE 1",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260623852",
            "telephone_number": "304-810-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3203 PENNSYLVANIA AVE STE 1",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260623852",
            "telephone_number": "304-810-2657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Market St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Steubenville",
            "state": "OH",
            "postal_code": "439522847",
            "country_code": "US",
            "telephone_number": "304-491-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-03",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1700307",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.1500446",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "009079",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "2528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weirton, WV

Sources for this page

Verify at the official NPI Registry.