Active NPI
Jennie Brogan, LPC
- Professional Counselor
- Radford, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701011225
- Practice address
- 401 W Main St
Radford, VA 24141-1588 - Phone
- (540) 838-8000
- Fax
- (540) 904-0051
- NPI assigned
- Feb 17, 2022
- Last updated
- Feb 21, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | 0701011225 | VA | Primary |
Addresses
Primary practice location
401 W Main St
Radford, VA 24141-1588
Mailing address
700 University City Blvd
Blacksburg, VA 24060-2706
Phone (540) 961-8388
Other names 1
- Jennie Brogan Kelly
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
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
Practice addresses (Care Compare)
106 Southpark Dr
Suite C
Blacksburg, VA 24060-6809
Phone (855) 284-7483
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701011225 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Counseling LLC | Mental Health | Current | Accepting new patients |
Locations
106 Southpark Dr
Ste C
Blacksburg, VA 24060
Phone (540) 361-6270
5310 Markel Rd
Ste 102
Richmond, VA 23230
Phone (804) 312-5498
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": "1645056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708473600000",
"number": "1841945979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 UNIVERSITY CITY BLVD",
"city": "BLACKSBURG",
"state": "VA",
"postal_code": "240602706",
"telephone_number": "540-961-8388",
"fax_number": "540-322-1847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 W MAIN ST",
"city": "RADFORD",
"state": "VA",
"postal_code": "241411588",
"telephone_number": "540-838-8000",
"fax_number": "540-904-0051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROGAN",
"first_name": "JENNIE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-17",
"last_updated": "2024-02-21",
"certification_date": "2024-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701011225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIE",
"last_name": "KELLY",
"middle_name": "BROGAN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Radford, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.