Philicia Jefferson, PH.D.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701003090 Issued in VA

Practice address

4936 Southpoint Pkwy
Fredericksburg, VA 22407-2659

Phone

(540) 710-0520

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Dr. Philicia Jefferson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Tree of Life Christian Counseling

  • Community/Behavioral Health Agency
  • Lynchburg, VA
  • NPI 1063740298
  NPD (past) Authorized official
• Tree of Life Christian Counseling Agency, LLC

  • Mental Health Counselor
  • Fredericksburg, VA
  • NPI 1699705459
  NPD (past) Authorized official

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259539200000",
    "number": "1730102518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42111",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224042111",
            "telephone_number": "703-490-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4936 SOUTHPOINT PKWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224072659",
            "telephone_number": "540-710-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "PHILICIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2009-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "441462",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005411041",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "258225000",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEGALLEN",
            "identifier": "258225000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHILICIA",
            "last_name": "JEFFERSON",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Roy William Jarnecke, PH.D.
• Helen McLaughlin Jarrett, AGACNP
• Jason T Lipscomb DDS P C
• Shayma M. Jawad, D.O.
• Jay David Brock, MD, PC
• Dave Jenkins, DMIN, LMFT
• Lisa Jenkins, M.D
• Teresa Martin Jenkins, LCSW
• Jenniferthompson FNP-BC LLC
• Abigail Jergenson, PT, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.