Individual provider Active NPI

Jessica Gregory

  • Professional Counselor
  • Bristol, VA
National Provider Identifier
1467950113
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701009022 Issued in VA
Practice address
261 North St
Bristol, VA 24201-3275
Phone
(276) 821-8030
NPI assigned
Jan 29, 2018
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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 5493 TN
Professional Counselor 101YP2500X 0701009022 VA Primary

Addresses

Primary practice location

261 North St
Bristol, VA 24201-3275

Mailing address

500 Springdale Dr
Bristol, TN 37620-0932
Phone (276) 780-3734

Other practice location 1

482 Bradley St SW
Abingdon, VA 24210-3008
Phone (276) 451-3996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 21, 2025 through Jan 21, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701009022VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical & Forensic Consultation, LLC Addiction (Substance Use Disorder) CurrentSince Jul 1, 2021 Accepting new patients

Locations

100 5th St
Ste 310
Bristol, TN 37620
Phone (423) 822-5099

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, 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": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1467950113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SPRINGDALE DR",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376200932",
            "telephone_number": "276-780-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 NORTH ST",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242013275",
            "telephone_number": "276-821-8030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "482 Bradley St SW",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242103008",
            "country_code": "US",
            "telephone_number": "276-451-3996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "5493",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701009022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, VA

Sources for this page

Verify at the official NPI Registry.