Active NPI
Jerrika Sychampanakhone
- Professional Counselor
- Harrisonburg, VA
National Provider Identifier
1891456604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701011091
- Practice address
- 35 Southgate CT Ste 101
Harrisonburg, VA 22801-9670 - Phone
- (615) 567-6726
- NPI assigned
- Jan 4, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701011091 | VA | Primary |
Addresses
Primary practice location
35 Southgate CT Ste 101
Harrisonburg, VA 22801-9670
Mailing address
35 Southgate CT Ste 101
Harrisonburg, VA 22801-9670
Phone (615) 567-6726
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701011091 | VA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641254400000",
"number": "1891456604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 SOUTHGATE CT STE 101",
"city": "HARRISONBURG",
"state": "VA",
"postal_code": "228019670",
"telephone_number": "615-567-6726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 SOUTHGATE CT STE 101",
"city": "HARRISONBURG",
"state": "VA",
"postal_code": "228019670",
"telephone_number": "615-567-6726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYCHAMPANAKHONE",
"first_name": "JERRIKA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-04",
"last_updated": "2022-01-04",
"certification_date": "2022-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701011091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrisonburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.