Individual provider Active NPI

Jessica Butler, LPC

  • Professional Counselor
  • Martinsville, VA
National Provider Identifier
1891265302
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701007995 Issued in VA
Practice address
24 Clay St
Martinsville, VA 24112-2810
Phone
(276) 632-7128
Fax
(276) 632-0127
NPI assigned
Nov 27, 2018
Last updated
Nov 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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 0701007995 VA Primary

Addresses

Primary practice location

24 Clay St
Martinsville, VA 24112-2810

Mailing address

24 Clay St
Martinsville, VA 24112-2810
Phone (276) 632-7128

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
I20240125004807 VA Practitioner - Mental Health Counselor 0648623678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Regional Community Services BoardGroup PAC ID 0345215208, 35 clinicians

Practice addresses (Care Compare)

22280 Jeb Stuart Hwy
Stuart, VA 24171-2999
Phone 27663271281339

24 Clay St
Martinsville, VA 24112-2810
Phone 27663271281339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Regional Community Services Board CurrentSince Jan 1, 2024 Accepting new patients

Locations

24 Clay St
Martinsville, VA 24112
Phone (276) 632-7128

22280 Jeb Stuart Hwy
Stuart, VA 24171
Phone (276) 632-7128

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": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1891265302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CLAY ST",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241122810",
            "telephone_number": "276-632-7128",
            "fax_number": "276-632-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 CLAY ST",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241122810",
            "telephone_number": "276-632-7128",
            "fax_number": "276-632-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JESSICA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701007995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsville, VA

Sources for this page

Verify at the official NPI Registry.