JENNIFER C NISSLEY
NPI 1104159169
Counselor - Mental Health in Freeburg, PA
About Jennifer C Nissley NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JENNIFER C NISSLEY (NPI 1104159169) is an individual mental health provider in Freeburg, Pennsylvania and active in the NPI registry since September 2009. She is enrolled in Medicare PECOS and is a graduate of Other (2010).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jennifer C Nissley is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jennifer Nissley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Miami, FL 33130
- Reassigned Medicare billing, Pennsylvania enrollment
- 833 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jennifer Nissley's NPI number?
The NPI number for Jennifer Nissley is 1104159169. It was assigned to this individual provider in the NPPES registry on September 9, 2009.
Where is Jennifer Nissley located?
Jennifer Nissley practices at 6 North Willow St, Freeburg, PA 17827. The listed phone number is (717) 991-5604.
What is Jennifer Nissley's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Jennifer Nissley enrolled in Medicare?
Yes. Jennifer Nissley is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jennifer Nissley's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Nissley reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jennifer Nissley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jennifer Nissley was last updated on December 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jennifer C Nissley · NPI 1104159169
Mental Health provider in Freeburg, Pennsylvania. Individual provider, active in the CMS NPPES registry since September 9, 2009.
## Identity
- **NPI:** 1104159169 (Entity type: Individual)
- **Enumerated:** September 9, 2009
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Sole proprietor:** No
## Practice location
- **Address:** 6 NORTH WILLOW ST, Freeburg, PA 17827-0000
- **Phone:** (717) 991-5604
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Grow Healthcare Group PA (NPI 1245845932, Miami, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2010
## Record status
- **NPPES last updated:** December 22, 2022
- **Other identifiers:** Medicaid 1007777400036 (PA)
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Source: [NPI Profile](https://npiprofile.com/npi/1104159169) · Data from the CMS NPPES public registry.