MEDICARE: JENNIFER C NISSLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104159169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER C NISSLEY

Provider Business Mailing Address
First Line	:	335 S FRANKLIN ST
Second Line	:
City	:	WILKES BARRE
State	:	PA
Zip	:	18702-3808
Country	:	US
Telephone Number	:	570-825-6425
Fax Number	:	570-762-9013

Provider Business Practice Location Address
First Line	:	6 NORTH WILLOW ST
Second Line	:
City	:	FREEBURG
State	:	PA
Zip	:	17827-0000
Country	:	US
Telephone Number	:	717-991-5604
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2009
Last Update Date	:	12/22/2022

Similar Medicare Providers

1801049242 — DR. WILLIAM LEONARD YINGLING M.D.
Practice Location Address:

307 E. NEW MARKET ST. , 307 E. NEW MARKET ST.
FREEBURG, PA
17827-0243

Practice Phone: 570-374-9533
Practice Fax:

1629489083 — DR. JASMINE REGGIA D.C.
Practice Location Address:

11 CHURCH STREET
FREEBURG, PA
17827

Practice Phone: 570-374-0100
Practice Fax:

1609616903 — SHANNON NICOLE MOYER MSW, LSW
Practice Location Address:

5 E NEW MARKET ST
FREEBURG, PA
17827-7714

Practice Phone: 412-350-9550
Practice Fax:

1134099773 — SARAH GEISER
Practice Location Address:

P.O. BOX 312
FREEBURG, PA
17827

Practice Phone: 570-850-7778
Practice Fax: 570-850-7778

1578741674 — MS. ERIN LEA GOEDEGEBUURE MA, LPC
Practice Location Address:

1372 N SUSQUEHANNA TRL
SELINSGROVE, PA
17870-8971

Practice Phone: 570-743-2323
Practice Fax:

1689366403 — ASHLEY LEE NEWMAN OTR/L
Practice Location Address:

631 MAIN ST
RICHFIELD, PA
17086-8691

Practice Phone: 717-694-3434
Practice Fax:

Directions to “ JENNIFER C NISSLEY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.