Jennifer J Mixson, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701006293 Issued in VA

Practice address

15521 Midlothian Tpke Ste 105
Midlothian, VA 23113-7313

Phone

(804) 207-6737

NPI assigned

Sep 25, 2015

Last updated

Nov 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Jennifer Mixson Randolph Former name

Medicare fee-for-service enrollment

Enrolled in VA, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Commonwealth Counseling Associates IncGroup PAC ID 0941288583, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Commonwealth Counseling Associates Inc

  dba LifeStance Health

  • Clinical Psychologist
  • Mechanicsville, VA
  • NPI 1851345805

  Professional

  Medicare reassignment Care Compare group NPD
• Curana Health Medical Group LLC

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1255640678
  Medicare reassignment NPD

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1396115960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15521 MIDLOTHIAN TPKE STE 105",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231137313",
            "telephone_number": "804-207-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15521 MIDLOTHIAN TPKE STE 105",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231137313",
            "telephone_number": "804-207-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIXSON",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-25",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701006293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30016005760002",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "RANDOLPH",
            "middle_name": "MIXSON",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victoria Elizabeth Mitchell
• Mitten Construction LLC
• Alicen Wray Mitterer, DPT
• Roy H Mittmann, O.D.
• Laura Carolyn Mixon
• Lily Rose Mlynarczyk
• Sumayra Mairaj Mohiuddin, DDS
• Corinne Pleasants Mohler, PHARMD
• Valerie Sue Mohrman, LCSW
• Momentum Counseling and Wellness LLC

• Professional Counselor in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.