Jacqueline I Barnette
Individual provider Active NPI Counselor · Chase City, VA
NPI 1831819978 · NPPES record last updated Jan 22, 2024
Key facts
- NPI
- 1831819978
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 0701011732 (VA)
- Practice address
- 11258 Highway Forty Seven
Chase City, VA 23924-3402 - Phone
- (434) 210-9239
- NPI assigned
- Aug 30, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
103 Summer Station Dr
Guyton, GA 31312-7145
11258 Hwy Forty Seven
Chase City, VA 23924-3402
2033 Home Park TRL
Apt 211
Prattville, AL 36066-7817
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- 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 |
|---|---|---|---|---|
| I20260615003646 | VA | Practitioner - Mental Health Counselor | 0840762415 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701011732 | VA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rising Development Center LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 0701011732 | VA | Yes |
Addresses
Primary practice location
11258 Highway Forty Seven
Chase City, VA 23924-3402
Mailing address
11258 Highway Forty Seven
Chase City, VA 23924-3402
Phone (434) 210-9239
Other providers in Chase City, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2024. 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.