JENNIFER L SOUTH (PC) – Professional Counselor, NPI 1114429131

JENNIFER L SOUTH (PC) is a healthcare provider. based in Bradford, Pennsylvania. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials PC. They hold a License No. PC004917 (PA). The NPI Number for JENNIFER L SOUTH (PC) is 1114429131

Main info

Female
30 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER L SOUTH (PC)
NPI
1114429131
Phone
(814) 362-6535
Address
110 CAMPUS DR
Enumeration Date
6 March 2018
Last Update Date
25 April 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8143626535
Graduation Year
1996 (30 years ago)
PAC ID
7719339720
Group Practice PAC ID
6103864681
Professional Enrollment ID
I20240116000639
Address ID
PA167011982BR110XXDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:8State licenses:2Digital endpointsOther names

2,541 MENTAL HEALTH COUNSELOR in PA

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Provider Addresses for JENNIFER L SOUTH (PC)

  • 110, Campus Drive, Bradford Township, McKean County, Pennsylvania, 16701, United States

    BRADFORD, PA 167011982

    Phone: (814) 362-6535

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240116000639IMental Health CounselorPATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 16701)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103864681View full group profile
NameSpecialtyState
Mental Health CounselorPA
Nurse PractitionerPA
P S Y C H I A T R YNY
Mental Health CounselorPA
P S Y C H I A T R YPA
Mental Health CounselorPA
-WY
Clinical Social WorkerPA
-NY
Mental Health CounselorNY

Reviews

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Frequently asked questions

How is JENNIFER L SOUTH (PC) identified in CMS data?
CMS-hosted NPPES data lists JENNIFER L SOUTH (PC) with NPI 1114429131.
Does the file indicate JENNIFER L SOUTH (PC) is practicing under active NPI?
Directory data currently reports JENNIFER L SOUTH (PC) as active.
What healthcare role does JENNIFER L SOUTH (PC) hold?
Scheduling teams often label JENNIFER L SOUTH (PC) under Professional Counselor. Clinical services aligned with this taxonomy classification.
Where should I expect JENNIFER L SOUTH (PC) on a map?
Expect Bradford, Pennsylvania as a primary anchor for JENNIFER L SOUTH (PC) unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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