Jennifer Lee

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

0717001999 Issued in VA

Practice address

10520 Judicial Dr
Fairfax, VA 22030-5115

Phone

(703) 246-2100

NPI assigned

Aug 27, 2021

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

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

Marriage and Family Therapist

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Law

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.

• Civitas Health Services, Inc.

  • Community/Behavioral Health Agency
  • Richmond, VA
  • NPI 1366727984
  Medicare reassignment NPD

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1497422257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 WILLOW OAKS CORPORATE DRIVE",
            "address_2": "CSB JAIL DIVERSION- 2 EAST",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22031",
            "telephone_number": "703-207-7706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10520 JUDICIAL DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305115",
            "telephone_number": "703-246-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4110 Chain Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220304020",
            "country_code": "US",
            "telephone_number": "703-691-7320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8221 Willow Oaks Corporate Drive",
            "address_2": "CSB Jail Diversion- 2 East",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "22031",
            "country_code": "US",
            "telephone_number": "703-207-7706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ho S Lee, MD
• Hoyon Lee, M.D.
• Iman Gabrielle Lee, FNP-BC
• Iris Lee, M.D.
• Jai K Lee, M.D.
• Jennifer Mary Lee, D.C.
• Jessica Lee, M.D.
• John H Lee, M.D.
• Joya Suzanne Lee, LCSW
• Juhee Lee

• Marriage & Family Therapist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Marriage & Family Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.