Individual provider Active NPI

Terri Jefferson, LPC

  • Counselor
  • Lansing, MI
National Provider Identifier
1164760682
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401006592 Issued in MI
Practice address
4710 W Saginaw Hwy Ste 1
Lansing, MI 48917-2654
Phone
(517) 816-2800
NPI assigned
Jan 17, 2013
Last updated
Jul 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401006592 MI Primary

Addresses

Primary practice location

4710 W Saginaw Hwy Ste 1
Lansing, MI 48917-2654

Mailing address

519 Tisdale Ave
Lansing, MI 48910-3319
Phone (517) 927-4989

Other names 1

  • Ms. Terri Beard Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • 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
I20240122003055 MI Practitioner - Mental Health Counselor 8224480629 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401006592MIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
A New Day Counseling Consulting and Community Services Counselor CurrentSince Jan 1, 2024 Accepting new patients
Fountain of Wisdom and Hope LLC Counselor PastSince Aug 2, 2020 Accepting new patients

Locations

4710 W Saginaw Hwy
Ste 1
Lansing, MI 48917
Phone (517) 816-2800

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1164760682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 TISDALE AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489103319",
            "telephone_number": "517-927-4989",
            "fax_number": "517-927-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 W SAGINAW HWY STE 1",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489172654",
            "telephone_number": "517-816-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "TERRI",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-17",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401006592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRI",
            "last_name": "BEARD",
            "prefix": "MS.",
            "credential": "MA, LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.