Individual provider Active NPI

Jason D O'Brien, LPC, LMFT

  • Professional Counselor
  • Blue Ridge, VA
National Provider Identifier
1851379432
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701002529 Issued in VA
Practice address
3522 Webster Rd
Blue Ridge, VA 24064
Phone
(540) 977-6300
Fax
(540) 977-9523
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0717000613 VA
Professional Counselor 101YP2500X 0701002529 VA Primary

Addresses

Primary practice location

3522 Webster Rd
Blue Ridge, VA 24064

Mailing address

3522 Webster Rd
Blue Ridge, VA 24064
Phone (540) 977-6300

Other identifiers 1

IdentifierTypeStateIssuer
005415756MedicaidVA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240612002682 VA Practitioner - Mental Health Counselor 4385186782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Botetourt Counseling Center IncGroup PAC ID 5799887642, 5 clinicians

Practice addresses (Care Compare)

3522 Webster Rd
Blue Ridge, VA 24064-1980
Phone (540) 977-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701002529VAMDProfessional Counselor
0717000613VAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Botetourt Counseling Center Inc CurrentSince Apr 29, 2024 Accepting new patients

Locations

3522 Webster Rd
Blue Ridge, VA 24064
Phone (540) 944-6300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1851379432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3522 WEBSTER RD",
            "city": "BLUE RIDGE",
            "state": "VA",
            "postal_code": "24064",
            "telephone_number": "540-977-6300",
            "fax_number": "540-977-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3522 WEBSTER RD",
            "city": "BLUE RIDGE",
            "state": "VA",
            "postal_code": "24064",
            "telephone_number": "540-977-6300",
            "fax_number": "540-977-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "JASON",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "LPC, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717000613",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701002529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005415756",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ridge, VA

Sources for this page

Verify at the official NPI Registry.