Mackenzie Jardell

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0704014593 Issued in VA

Practice address

7150 Heritage Village PLZ Ste 201
Gainesville, VA 20155-3064

Phone

(571) 318-9141

NPI assigned

Feb 16, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 27, 2025 through Feb 27, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Clarity Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gainesville, VA
  • NPI 1740932185
  NPD

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1871248955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 N UTAH ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222015730",
            "telephone_number": "409-719-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 HERITAGE VILLAGE PLZ STE 201",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553064",
            "telephone_number": "571-318-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARDELL",
        "first_name": "MACKENZIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0704014593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrous Health Systems, Inc.
• Internal Medicine and Wellness, PC
• Isg Transport, LLC
• Amal Isse
• Jobin V James, DPT
• Claire E. Jenkins, CRNA
• Leland Kent Jensen
• Laura Lazarus Jessup, LPC, NCC
• John Patrick Jezior
• Jing Guo, O.D.

• Mental Health Counselor in Gainesville, VA
• Providers in Gainesville, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.