Active NPI
Jenelle Crescimbeni
- Professional Counselor
- Dumfries, VA
National Provider Identifier
1891478426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0704015894
- Practice address
- 17932 Fraley Blvd
Dumfries, VA 22026-2485 - Phone
- (571) 636-1800
- NPI assigned
- Aug 10, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | 0704015894 | VA | Primary |
Addresses
Primary practice location
17932 Fraley Blvd
Dumfries, VA 22026-2485
Mailing address
15151 Athey Loop
Woodbridge, VA 22193-6231
Phone (254) 466-7685
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 |
|---|---|---|---|
| 0704015894 | VA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691625600000",
"number": "1891478426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15151 ATHEY LOOP",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221936231",
"telephone_number": "254-466-7685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17932 FRALEY BLVD",
"city": "DUMFRIES",
"state": "VA",
"postal_code": "220262485",
"telephone_number": "571-636-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRESCIMBENI",
"first_name": "JENELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-10",
"last_updated": "2023-08-10",
"certification_date": "2023-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0704015894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dumfries, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.