NPIMap

Organization Active NPI

Life Source Counseling Center, Inc

  • Clinical Social Worker
  • Fredericksburg, VA
National Provider Identifier
1801565999
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LIFE SOURCE COUNSELING CENTER, INC
Practice address
3516 Plank Rd Ste 5C
Fredericksburg, VA 22407-6861
Phone
(540) 786-3049
Fax
(540) 301-2403
NPI assigned
Sep 10, 2021
Last updated
Sep 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Authorized official

Name
Crystal Rochelle Jones, LCSWNPI 1225455462
Title
Owner
Phone
(301) 523-3642

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

3516 Plank Rd Ste 5C
Fredericksburg, VA 22407-6861

Mailing address

3516 Plank Rd Ste 5C
Fredericksburg, VA 22407-6861
Phone (301) 523-3642

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1801565999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3516 PLANK RD STE 5C",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076861",
            "telephone_number": "301-523-3642",
            "fax_number": "540-301-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3516 PLANK RD STE 5C",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076861",
            "telephone_number": "540-786-3049",
            "fax_number": "540-301-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SOURCE COUNSELING CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "ROCHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-523-3642",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.