Active NPI
Jaclyn Michelle Sargent, LPC, ATR-BC, LCPAT
- Mental Health Counselor
- Annandale, VA
National Provider Identifier
1972055150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0701006837
- Practice address
- 5101A Backlick Rd
Annandale, VA 22003-6080 - Phone
- (571) 418-1714
- Fax
- (703) 333-5023
- NPI assigned
- Nov 3, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0701006837 | VA | Primary |
Addresses
Primary practice location
5101A Backlick Rd
Annandale, VA 22003-6080
Mailing address
5101A Backlick Rd
Annandale, VA 22003-6080
Phone (571) 418-1714
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 |
|---|---|---|---|
| 0701006837 | VA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478131200000",
"number": "1972055150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5101A BACKLICK RD",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "220036080",
"telephone_number": "571-418-1714",
"fax_number": "703-333-5023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5101A BACKLICK RD",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "220036080",
"telephone_number": "571-418-1714",
"fax_number": "703-333-5023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SARGENT",
"first_name": "JACLYN",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "LPC, ATR-BC, LCPAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-03",
"last_updated": "2016-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "0701006837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Annandale, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.