Connie Lynn Jenks, LPC
Individual provider Active NPI Professional Counselor · Falls Church, VA
NPI 1598083792 · NPPES record last updated Jan 9, 2025
Key facts
- NPI
- 1598083792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 0701004851 (VA)
- Practice address
- 6565 Arlington Blvd Ste 405
Falls Church, VA 22042-3000 - Phone
- (703) 596-4796
- NPI assigned
- May 12, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- My Psychiatrist, LLC
Practice addresses (Care Compare)
12359 Sunrise Valley Dr
Suite 320
Reston, VA 20191-3463
Phone (703) 596-4796
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250815002848 | DC | Practitioner - Mental Health Counselor | 7517466600 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| My Psychiatrist LLC | Current |
Accepting new patients | |
| Hanover County Board of Supervisors | Past | Accepting new patients | |
| Hanover County Board of Supervisors | Past | Accepting new patients | |
| Healing Hearts VA, LLC | Past | Accepting new patients |
Locations
6565 Arlington Blvd
Ste 405
Falls Church, VA 22042
Phone (571) 946-2189
12359 Sunrise Valley Dr
Ste 320
Reston, VA 20191
Phone (703) 596-4796
12359 Sunrise Valley Dr
#32
Reston, VA 20191
Phone (703) 596-4796
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Clinical Social Worker | 1041C0700X | VA | ||
| Professional Counselor | 101YP2500X | 0701004851 | VA | Yes |
Addresses
Primary practice location
6565 Arlington Blvd Ste 405
Falls Church, VA 22042-3000
Mailing address
384 Gan Way
St Johns, FL 32259-9403
Phone (804) 683-2923
Other practice location 1
41920 Beckett Farms Ter
Aldie, VA 20105-3233
Phone (703) 677-8693
Other providers in Falls Church, VA
- Amy R Jeffery
- Michelle Wilson Jeffery
- Jeffrey L Brown, DDS, PLC
- Maria Jeffries
- Darcy Jenkins
- Jennifer Lanouette LCSW
- Aimee Elizabeth Jennings
- Faith Elizabeth Jennings
- Katherine Jennings
- Hyungjoo Jeong
All providers in Falls Church, VA · Professional Counselor in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.