Individual provider Active NPI

Jessica Echeverry, LPC

  • Professional Counselor
  • McLean, VA
National Provider Identifier
1841752722
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701010609 Issued in VA
Practice address
1360 Beverly Rd Ste 200
MC Lean, VA 22101-3647
Phone
(703) 831-8300
NPI assigned
Apr 1, 2019
Last updated
Dec 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701010609 VA Primary

Addresses

Primary practice location

1360 Beverly Rd Ste 200
MC Lean, VA 22101-3647

Mailing address

1360 Beverly Rd Ste 200
MC Lean, VA 22101-3647
Phone (804) 207-6737

Other identifiers 1

IdentifierTypeStateIssuer
30015824440006MedicaidVA

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
I20240105003482 DC Practitioner - Mental Health Counselor 6204287055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Counseling Associates IncGroup PAC ID 0941288583, 207 clinicians

Practice addresses (Care Compare)

1360 Beverly Rd
Suite 200
MC Lean, VA 22101-3647
Phone (703) 831-8300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701010609VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Counseling Associates Inc Counselor CurrentSince Jan 1, 2024 Accepting new patients

Locations

1005 N Glebe Rd
Ste 525
Arlington, VA 22201
Phone (703) 962-7605

1360 Beverly Rd
Ste 200
McLean, VA 22101
Phone (203) 246-9073

9202 Center Oak Ct
Mechanicsvlle, VA 23116
Phone (804) 639-1112

Interoperability endpoints

  • Direct secure messaging: granatogroup.jessicaecheverry@144557.advancedmd-direct.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1841752722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 BEVERLY RD STE 200",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013647",
            "telephone_number": "804-207-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 BEVERLY RD STE 200",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013647",
            "telephone_number": "703-831-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECHEVERRY",
        "first_name": "JESSICA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701010609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30015824440006",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

Verify at the official NPI Registry.