Individual provider Active NPI

Jennifer Zegan-Lister, MS, LPC

  • Counselor
  • Richmond, VA
National Provider Identifier
1205697182
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
0701013237 Issued in VA
Practice address
4807 Hermitage Rd Ste 203
Richmond, VA 23227-3335
Phone
(804) 372-3290
NPI assigned
Jan 18, 2024
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 0701013237 VA Primary

Addresses

Primary practice location

4807 Hermitage Rd Ste 203
Richmond, VA 23227-3335

Mailing address

4807 Hermitage Rd Ste 203
Richmond, VA 23227-3335
Phone (804) 372-3290

Other practice location 1

804 Moorefield Park Dr Ste 204
North Chesterfield, VA 23236-3670
Phone (804) 372-3290

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0701013237VAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Radical Empathy Counseling LLC Current Accepting new patients
Pagano Wellness Clinic Counselor PastSince Jan 1, 2024 Accepting new patients

Locations

804 Moorefield Park Dr
Ste 204
North Chesterfield, VA 23236
Phone (804) 372-3737

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1205697182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4807 HERMITAGE RD STE 203",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232273335",
            "telephone_number": "804-372-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4807 HERMITAGE RD STE 203",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232273335",
            "telephone_number": "804-372-3290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "804 Moorefield Park Dr Ste 204",
            "address_purpose": "LOCATION",
            "city": "North Chesterfield",
            "state": "VA",
            "postal_code": "232363670",
            "country_code": "US",
            "telephone_number": "804-372-3290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZEGAN-LISTER",
        "first_name": "JENNIFER",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "U",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": "0701013237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.