Individual provider Active NPI

Jarel Brown

  • Professional Counselor
  • Forest, VA
National Provider Identifier
1972126365
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701009067 Issued in VA
Practice address
316 Brook Park PL
Forest, VA 24551-2766
Phone
(434) 533-1088
NPI assigned
May 20, 2020
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701009067 VA Primary

Addresses

Primary practice location

316 Brook Park PL
Forest, VA 24551-2766

Mailing address

2215 Langhorne Rd
Lynchburg, VA 24501-1121

Other practice location 1

2215 Langhorne Rd
Lynchburg, VA 24501-1121
Phone (434) 948-4831

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

LicenseStateTypeSpecialty
0701009067VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Living Services Professional CurrentSince Oct 1, 2020 Accepting new patients
Horizon Behavioral Health CurrentSince Dec 26, 2021 Accepting new patients

Locations

316 Brook Park Pl
Forest, VA 24551
Phone (434) 515-0877

2215 Langhorne Rd
Lynchburg, VA 24501
Phone (434) 948-4831

Organizations & group practices 2

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": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1972126365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 LANGHORNE RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 BROOK PARK PL",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512766",
            "telephone_number": "434-533-1088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Langhorne Rd",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "245011121",
            "country_code": "US",
            "telephone_number": "434-948-4831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JAREL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701009067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.