Jennifer Fredette, MA, M.DIV

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701006603 Issued in VA

Practice address

1716 Chain Bridge Rd
MC Lean, VA 22101-4322

Phone

(703) 903-9696

Fax

(703) 821-2505

NPI assigned

Mar 4, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Jenn Fredette Psychotherapy LLC

  • Counselor
  • Elkridge, MD
  • NPI 1366126104
  NPD Authorized official
• Center for Pastoral Counseling of Virginia

  • Pastoral Counselor
  • MC Lean, VA
  • NPI 1104328335
  NPD (past)

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1912367806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX QQ",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221010700",
            "telephone_number": "703-903-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 CHAIN BRIDGE RD",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221014322",
            "telephone_number": "703-903-9696",
            "fax_number": "703-821-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDETTE",
        "first_name": "JENNIFER",
        "credential": "MA, M.DIV",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-04",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701006603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ylando Footman
• Philip Forsythe, DPT
• Adam Foster, DPT, PT
• Majid Fotuhi, M.D., PHD
• Fred E. Goldberg O.D., F.a.a.O., PC
• Mayo F Friedlis, MD
• Rachel Elizabeth Frietchen
• Lawrence Addo Frimpong
• Francis Edwin Froelich, M.D.
• Fuad Issa MD PLLC

• Professional Counselor in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.