Organization Active NPI

Diana Jamison LCSW PLLC

  • Adult Mental Health Clinic/Center
  • Kilmarnock, VA
National Provider Identifier
1114184165
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
0904000993 Issued in VA
Legal business name
DIANA JAMISON LCSW PLLC
Practice address
25 Office Park Drive
Kilmarnock, VA 22482-0877
Phone
(804) 436-9218
Fax
(804) 435-6836
NPI assigned
May 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Authorized official

Name
Diana Jamison, MSW LCSWNPI 1508800277
Title
Member Manager
Phone
(804) 436-9218

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 0904000993 VA Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 0904000993 VA

Addresses

Primary practice location

25 Office Park Drive
Kilmarnock, VA 22482-0877

Mailing address

PO Box 877
Kilmarnock, VA 22482-0877
Phone (804) 436-9218

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081229000105 VA Part B Supplier - Clinic/Group Practice 0749342863 Receives reassigned benefits from 1 practitioner
Practice locations: Gloucester, VA; Kilmarnock, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1114184165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 877",
            "city": "KILMARNOCK",
            "state": "VA",
            "postal_code": "224820877",
            "telephone_number": "804-436-9218",
            "fax_number": "804-435-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 OFFICE PARK DRIVE",
            "city": "KILMARNOCK",
            "state": "VA",
            "postal_code": "224820877",
            "telephone_number": "804-436-9218",
            "fax_number": "804-435-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANA JAMISON LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "JAMISON",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "804-436-9218",
        "authorized_official_credential": "MSW   LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "VA",
            "license": "0904000993",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "VA",
            "license": "0904000993",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kilmarnock, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.