Active NPI
KJLN Inc.
- Community/Behavioral Health Agency
- Chesapeake, VA
National Provider Identifier
1306491592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- KJLN INC.
- Practice address
- 4020 Portsmouth Blvd
Chesapeake, VA 23321-2126 - Phone
- (757) 529-8844
- Fax
- (757) 525-4927
- NPI assigned
- Aug 5, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nicholas Moyer
- Title
- Ceo
- Phone
- (276) 806-4418
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
4020 Portsmouth Blvd
Chesapeake, VA 23321-2126
Mailing address
4208 Helen St
Suffolk, VA 23435-2138
Phone (276) 806-4418
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3316 | Medicaid | VA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nm@lifeconsultantsinc.org |
National Provider Directory
National Provider Directory- Tax ID family
- KJLN Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- Suffolk, VA
- NPI 1588915672
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564963200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1676851200000",
"number": "1306491592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4208 HELEN ST",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234352138",
"telephone_number": "276-806-4418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4020 PORTSMOUTH BLVD",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233212126",
"telephone_number": "757-529-8844",
"fax_number": "757-525-4927"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KJLN INC.",
"organizational_subpart": "NO",
"enumeration_date": "2019-08-05",
"last_updated": "2023-02-20",
"certification_date": "2023-02-20",
"status": "A",
"authorized_official_last_name": "MOYER",
"authorized_official_first_name": "NICHOLAS",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "276-806-4418"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3316",
"state": "VA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nm@lifeconsultantsinc.org",
"affiliation": "N",
"address_1": "4208 Helen St",
"city": "Suffolk",
"state": "VA",
"country_code": "US",
"postal_code": "234352138",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.