Individual provider Active NPI

Jessica Lyn Williams, LPC

  • Professional Counselor
  • Reston, VA
National Provider Identifier
1942788161
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701007707 Issued in VA
Practice address
1850 Cameron Glen Dr
Reston, VA 20190-3363
Phone
(703) 481-4100
NPI assigned
Jul 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701007707 VA Primary
Mental Health Counselor 101YM0800X 0701007707 VA

Addresses

Primary practice location

1850 Cameron Glen Dr
Reston, VA 20190-3363

Mailing address

1850 Cameron Glen Dr Ste 600
Reston, VA 20190-3343

Other names 1

  • Jessica Lyn Nobs Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701007707VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax County, Virginia CurrentSince Jan 1, 2024 Accepting new patients

Locations

8119 Holland Rd
Alexandria, VA 22306
Phone (703) 360-6910

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031
Phone (703) 289-7599

12011 Government Center Pkwy
Ste 836
Fairfax, VA 22035
Phone (703) 324-7017

1850 Cameron Glen Dr
Ste 600
Reston, VA 20190
Phone (703) 481-4100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1942788161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 CAMERON GLEN DR STE 600",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 CAMERON GLEN DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903363",
            "telephone_number": "703-481-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JESSICA",
        "middle_name": "LYN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701007707",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701007707",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "NOBS",
            "middle_name": "LYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.