Shawnte Jefferies

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC9609 Issued in MD

Practice address

1401 Mercantile LN Ste 521
Largo, MD 20774-4301

Phone

(202) 391-1307

NPI assigned

Sep 29, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Community Wellness Group

  • Community/Behavioral Health Agency
  • Capitol Heights, MD
  • NPI 1639918972
  NPD Authorized official
• Transcend Wellness

  • Community/Behavioral Health Agency
  • Largo, MD
  • NPI 1285371088
  NPD Authorized official

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1417466731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6823 JADE CT",
            "city": "CAPITOL HEIGHTS",
            "state": "MD",
            "postal_code": "207431873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN STE 521",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744301",
            "telephone_number": "202-391-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERIES",
        "first_name": "SHAWNTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-29",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "LGP8051",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC9609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Dianne Jackson, PT
• Glen Mirandilla Jacob, MD
• Frances Antionette James, LCSW-C
• Emery Jefferies, LGSW
• Raymond Jefferies
• Susan E Jenkins, M.D
• Elisabeth Jiang, MD
• John W Bedeau, MD PC
• Carl Johnson, MD
• Cynthia Johnson, LDN

• Professional Counselor in Largo, MD
• Providers in Largo, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.

Verify at the official NPI Registry.