Individual provider Active NPI

Jennifer G Diehl, LCSW

  • Mental Health Counselor
  • Mechanicsville, VA
National Provider Identifier
1942307061
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0904004730 Issued in VA
Practice address
9044 Mann Dr
Mechanicsville, VA 23116-2312
Phone
(804) 647-9802
Fax
(804) 746-5150
NPI assigned
Sep 20, 2006
Last updated
Apr 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0904004730 VA Primary

Addresses

Primary practice location

9044 Mann Dr
Mechanicsville, VA 23116-2312

Mailing address

PO Box 3372
Mechanicsville, VA 23116-0032
Phone (804) 647-9802

Other identifiers 1

IdentifierTypeStateIssuer
004945425MedicaidVA

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
I20140515001798 VA Practitioner - Clinical Social Worker 6800019175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9044 Mann Dr
Mechanicsville, VA 23116-2312
Phone (804) 647-9802

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904004730VAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral & Counseling Services of Hanover, LLC CurrentSince Feb 15, 2014 Accepting new patients
Hanover County Board of Supervisors Mental Health Past Accepting new patients
Hanover County Board of Supervisors Past Accepting new patients

Locations

9044 Mann Dr
Mechanicsvlle, VA 23116
Phone (804) 647-9802

Organizations & group practices 3

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1942307061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3372",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231160032",
            "telephone_number": "804-647-9802",
            "fax_number": "804-746-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9044 MANN DR",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231162312",
            "telephone_number": "804-647-9802",
            "fax_number": "804-746-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEHL",
        "first_name": "JENNIFER",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0904004730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945425",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

Verify at the official NPI Registry.