JESSICA LYN DEBOLT
NPI 1760150700
Counselor in West Columbia, SC

Active since September 03, 2021PECOS EnrolledAccepts Medicare Assignment
3969 SOUTHEASTERN WAY, WEST COLUMBIA, SC 29169(803) 851-4049 Get Directions Write a Review

NPPES record last updated: November 4, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jessica Lyn Debolt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA LYN DEBOLT (NPI 1760150700) is an individual counselor in West Columbia, South Carolina, licensed in South Carolina (7738) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1760150700
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameJESSICA LYN DEBOLT
Location Address3969 SOUTHEASTERN WAYWest Columbia, SC 29169-2442
Mailing Address7837 Exeter LnColumbia, SC 29223-2519 · (315) 775-6054
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateSeptember 3, 2021
Last NPPES UpdateNovember 4, 2025
NPPES CertifiedNovember 4, 2025
NPI 1760150700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License Licensed in SC · 7738
Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 9089 (SC)
3969 SOUTHEASTERN WAY, West Columbia, SC 29169

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jessica Lyn Debolt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4284154782
PECOS Enrollment IDI20250227002496
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
3969 SOUTHEASTERN WAY
WEST COLUMBIA, SC 29169
Counselor (Mental Health)
3969 SOUTHEASTERN WAY
WEST COLUMBIA, SC 29169
Counselor (Professional)
3969 SOUTHEASTERN WAY, SUITE C
WEST COLUMBIA, SC 29169

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 Jessica Debolt's NPI number?

The NPI number for Jessica Debolt is 1760150700. It was assigned to this individual provider in the NPPES registry on September 3, 2021.

Where is Jessica Debolt located?

Jessica Debolt practices at 3969 Southeastern Way, West Columbia, SC 29169. The listed phone number is (803) 851-4049.

What is Jessica Debolt's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Jessica Debolt enrolled in Medicare?

Yes. Jessica Debolt is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jessica Debolt was last updated on November 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.