Individual provider Active NPI

Jerrica Chenae Newsome, LPC

  • Mental Health Counselor
  • Norfolk, VA
National Provider Identifier
1679287312
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0704011696 Issued in VA
Practice address
2200 Colonial Ave
Norfolk, VA 23517-1915
Phone
(757) 937-5780
Fax
(757) 937-5781
NPI assigned
Jan 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0704011696 VA Primary

Addresses

Primary practice location

2200 Colonial Ave
Norfolk, VA 23517-1915

Mailing address

2200 Colonial Ave Ste 11
Norfolk, VA 23517-1919
Phone (757) 937-5780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20240925000967 DC Practitioner - Mental Health Counselor 8628519055 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0704011696VAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifewell Psychotherapy LLC Current Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Aug 23, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1679287312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 COLONIAL AVE STE 11",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235171919",
            "telephone_number": "757-937-5780",
            "fax_number": "757-937-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 COLONIAL AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235171915",
            "telephone_number": "757-937-5780",
            "fax_number": "757-937-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWSOME",
        "first_name": "JERRICA",
        "middle_name": "CHENAE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0704011696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.