Organization Active NPI

Jefferson and Associates Psychological Services, P.C.

  • Clinical Psychologist
  • Lynchburg, VA
National Provider Identifier
1124133327
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810001866 Issued in VA
Legal business name
JEFFERSON AND ASSOCIATES PSYCHOLOGICAL SERVICES, P.C.
Practice address
3712 Old Forest Rd
Suite 500
Lynchburg, VA 24501-6959
Phone
(434) 385-0744
Fax
(434) 385-8358
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Authorized official

Name
Dr. Terry W. Jefferson, PH.D.
Title
Owner/President
Phone
(434) 385-0744

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 0810001866 VA Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X VA

Addresses

Primary practice location

3712 Old Forest Rd
Suite 500
Lynchburg, VA 24501-6959

Mailing address

3712 Old Forest Rd
Suite 500
Lynchburg, VA 24501-6959
Phone (434) 385-0744

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1124133327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3712 OLD FOREST RD",
            "address_2": "SUITE 500",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245016959",
            "telephone_number": "434-385-0744",
            "fax_number": "434-385-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3712 OLD FOREST RD",
            "address_2": "SUITE 500",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245016959",
            "telephone_number": "434-385-0744",
            "fax_number": "434-385-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON AND ASSOCIATES PSYCHOLOGICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2015-07-31",
        "status": "A",
        "authorized_official_last_name": "JEFFERSON",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "434-385-0744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001866",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.