Individual provider Active NPI

Jada E Overton, LCSW

  • Clinical Social Worker
  • Chesterfield, VA
National Provider Identifier
1396185187
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008256 Issued in VA
Practice address
6801 Lucy Corr CT
Chesterfield, VA 23832-6657
Phone
(804) 748-1227
NPI assigned
Jun 26, 2013
Last updated
Jun 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904008256 VA Primary

Addresses

Primary practice location

6801 Lucy Corr CT
Chesterfield, VA 23832-6657

Mailing address

6801 Lucy Corr CT
Chesterfield, VA 23832-6657
Phone (804) 748-1227

Other identifiers 1

IdentifierTypeStateIssuer
004945352MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20131021001166 VA Practitioner - Clinical Social Worker 3577798925 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904008256VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Chesterfield Virginia CurrentSince Aug 1, 2013 Accepting new patients
County of Chesterfield Virginia Clinical CurrentSince Aug 1, 2013 Accepting new patients
Chesterfield County Mental Health Past Accepting new patients
Chesterfield County Mental Health Past Accepting new patients

Locations

6801 Lucy Corr Ct
Chesterfield, VA 23832
Phone (804) 748-1227

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1396185187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 LUCY CORR CT",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326657",
            "telephone_number": "804-748-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 LUCY CORR CT",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326657",
            "telephone_number": "804-748-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERTON",
        "first_name": "JADA",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945352",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, VA

Sources for this page

Verify at the official NPI Registry.