Individual provider Active NPI

Jennie Antonette Sitman

  • Professional Counselor
  • Roanoke, VA
National Provider Identifier
1205496353
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701008430 Issued in VA
Practice address
5220 Hazelridge Rd NW
Roanoke, VA 24012-1542
Phone
(540) 254-4998
NPI assigned
Jun 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701008430 VA Primary

Addresses

Primary practice location

5220 Hazelridge Rd NW
Roanoke, VA 24012-1542

Mailing address

171 Wildhurst Ave NE
Roanoke, VA 24012-3637
Phone (540) 257-4998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0701008430VAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1205496353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 WILDHURST AVE NE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240123637",
            "telephone_number": "540-257-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 HAZELRIDGE RD NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240121542",
            "telephone_number": "540-254-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SITMAN",
        "first_name": "JENNIE",
        "middle_name": "ANTONETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701008430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; 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.