Individual provider Active NPI

Jennifer E Fasel, MSED

  • Counselor
  • Big Stone Gap, VA
National Provider Identifier
1962674432
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
3169 2ND Ave E
Big Stone Gap, VA 24219-3805
Phone
(276) 523-8300
Fax
(423) 467-3644
NPI assigned
Mar 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 1269 KY
Counselor 101Y00000X TN Primary

Addresses

Primary practice location

3169 2ND Ave E
Big Stone Gap, VA 24219-3805

Mailing address

1167 Spratlin Park Dr
Gray, TN 37615-6205
Phone (423) 467-3600

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

NPI Registry JSON

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1962674432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 SPRATLIN PARK DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376156205",
            "telephone_number": "423-467-3600",
            "fax_number": "423-467-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3169 2ND AVE E",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "242193805",
            "telephone_number": "276-523-8300",
            "fax_number": "423-467-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASEL",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "credential": "MSED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-25",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "KY",
            "license": "1269",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Stone Gap, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; 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.