Individual provider Active NPI

Lanita Jefferson, LPC

  • Mental Health Counselor
  • Columbia, SC
National Provider Identifier
1124669072
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7453 Issued in SC
Practice address
1103 Belleview St Ste 104
Columbia, SC 29201-1871
Phone
(803) 315-0302
NPI assigned
Oct 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 7453 SC Primary

Addresses

Primary practice location

1103 Belleview St Ste 104
Columbia, SC 29201-1871

Mailing address

1103 Belleview St Ste 104
Columbia, SC 29201-1871
Phone (803) 315-0302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240402002559 SC Practitioner - Mental Health Counselor 9133567761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1103 Belleview St
Suite 104
Columbia, SC 29201-1871
Phone (803) 318-9826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7453SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Wellness and Consulting LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

1103 Belleview St
Ste 104
Columbia, SC 29201
Phone (803) 315-0302

1111 Belleview St
Ste 101
Columbia, SC 29201
Phone (803) 318-9826

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1124669072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 BELLEVIEW ST STE 104",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292011871",
            "telephone_number": "803-315-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 BELLEVIEW ST STE 104",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292011871",
            "telephone_number": "803-315-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "LANITA",
        "name_prefix": "Dr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "7453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.