Individual provider Active NPI

Jamie J Plesko, LPC

  • Professional Counselor
  • Fairfax, VA
National Provider Identifier
1346740271
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701014104 Issued in VA
Practice address
4410 Shirley Gate Rd
Fairfax, VA 22030-5518
Phone
(703) 205-9452
NPI assigned
Feb 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701014104 VA Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

4410 Shirley Gate Rd
Fairfax, VA 22030-5518

Mailing address

4410 Shirley Gate Rd
Fairfax, VA 22030-5518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20250110003418 DC Practitioner - Mental Health Counselor 0446788913 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701014104VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax County, Virginia CurrentSince Dec 8, 2024 Accepting new patients

Locations

4410 Shirley Gate Rd
Fairfax, VA 22030
Phone (703) 205-9452

12011 Government Center Pkwy
Ste 836
Fairfax, VA 22035
Phone (703) 324-7017

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": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1346740271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 SHIRLEY GATE RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 SHIRLEY GATE RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305518",
            "telephone_number": "703-205-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLESKO",
        "first_name": "JAMIE",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701014104",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.