Jodi Latoya Herndon, LPC, LSATP, CSAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701008841 Issued in VA

Practice address

1110 Rose Hill Dr
Suite 201
Charlottesville, VA 22903

Phone

(540) 840-6763

NPI assigned

Aug 18, 2020

Last updated

Aug 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jodiherndon@tdh.allscriptsdirect.net

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.

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  Medicare reassignment NPD
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  Professional

  NPD

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1447862933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 811",
            "city": "ORANGE",
            "state": "VA",
            "postal_code": "229600474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 ROSE HILL DR",
            "address_2": "SUITE 201",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22903",
            "telephone_number": "540-840-6763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "363 Harper Dr",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "VA",
            "postal_code": "22960",
            "country_code": "US",
            "telephone_number": "540-840-6763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNDON",
        "first_name": "JODI",
        "middle_name": "LATOYA",
        "credential": "LPC, LSATP, CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0718000425",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701008841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "endpointDescription": "Apple MacBook Pro",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "363 Harper Dr",
            "city": "Orange",
            "state": "VA",
            "country_code": "US",
            "postal_code": "22960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Boor Hereford, LCSW
• Catherine Armstrong Herman
• Mario Jose Hernandez Carcamo, MD
• Laura Meilink Hernandez, BCBA
• Elena F. Herndon, M.D.
• Susan C Herndon, NP
• Dana R. Herr, LCSW
• Jenniffer T Herrera, MD
• Pamila A. Herrington, M.D.
• Laura Herron, PHD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.