Jenna Kelley, MS, LPC, ATR

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

8500 Executive Park Ave Ste 202
Fairfax, VA 22031-2253

Phone

(703) 852-7020

NPI assigned

Nov 6, 2020

Last updated

Nov 6, 2020By the provider in NPPES

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 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

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Afshar Brothers Inc.

  dba Ellie Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Herndon, VA
  • NPI 1629787809

  DC

  Medicare reassignment NPD
• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061
  NPD

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1801497615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 CERALENE DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220321703",
            "telephone_number": "757-802-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 EXECUTIVE PARK AVE STE 202",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312253",
            "telephone_number": "703-852-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JENNA",
        "credential": "MS, LPC, ATR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith K. Ewell, PH.D.
• Courtney Ann Kelchlin, PHARMD
• Joan Kelleher
• Barbara B Keller, PH.D.
• Kaitlyn Rae Kellermeyer
• Kayla M Kelley, M.S., SLP-CCC
• Shannon Marie Kelley, M.ED, BCBA
• Daniel P. Kelliher, D.D.S
• Gary M. Kellman, MD
• Lisa M Kellogg, LPC, LMFT

• Professional Counselor in Fairfax, VA
• Providers in Fairfax, 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 6, 2020; 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.