Individual provider Active NPI

Jennifer Riemersma, MA, LPC

  • Professional Counselor
  • Marietta, GA
National Provider Identifier
1972979193
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
10026 Issued in GA
Practice address
895 Banford CT NE
Marietta, GA 30068-4202
Phone
(678) 401-3825
NPI assigned
Aug 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 10026 GA Primary

Addresses

Primary practice location

895 Banford CT NE
Marietta, GA 30068-4202

Mailing address

895 Banford CT NE
Marietta, GA 30068-4202
Phone (678) 401-3825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 26, 2024 through Jan 26, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
10026GAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1972979193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 BANFORD CT NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684202",
            "telephone_number": "678-401-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 BANFORD CT NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684202",
            "telephone_number": "678-401-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEMERSMA",
        "first_name": "JENNIFER",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "10026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.