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ROSE R JETER LCSW
NPI 1750742201
Social Worker - Clinical in Petersburg, VA

Active since March 11, 2016Opted out of Medicare · through Jul 1, 2028
115 S SYCAMORE ST, SUITE B, PETERSBURG, VA 23803(804) 835-9511(804) 479-3373 Get Directions Write a Review

NPPES record last updated: May 28, 2016. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Rose R Jeter Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROSE R JETER LCSW (NPI 1750742201) is an individual clinical provider in Petersburg, Virginia, licensed in Virginia (0904009125) and active in the NPI registry since March 2016. She has opted out of Medicare through July 1, 2028.

NPPES Registry Identity

NPI1750742201
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameROSE R JETERCredential: LCSW
Location Address115 S SYCAMORE ST, SUITE BPetersburg, VA 23803-4279
Mailing Address115 S Sycamore St, Suite BPetersburg, VA 23803-4279 · (804) 835-9511 · Fax (804) 479-3373
Phone(804) 835-9511
Fax(804) 479-3373
Sole ProprietorYes
Enumeration DateMarch 11, 2016
Last NPPES UpdateMay 28, 2016
✔ NPI 1750742201 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in VA · 0904009125✔ Licensed in NY · 083428
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
115 S SYCAMORE ST, Petersburg, VA 23803
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Rose R Jeter Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2024 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2024
Opt-Out In Effect ThroughJuly 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIAJAH AISHAH MAY QMHP-A/C
Counselor (Addiction (Substance Use Disorder))
115 S SYCAMORE ST
PETERSBURG, VA 23803
Dinwiddie County (434) 294-5601
NEW BEGINNING IN-HOME CARE
Home Health
115 S SYCAMORE ST
PETERSBURG, VA 23803
Dinwiddie County (434) 294-0982
HEALTHY MINDS SUPPORTIVE INTERVENTIONS
Community/Behavioral Health
115 S SYCAMORE ST
PETERSBURG, VA 23803
Dinwiddie County (434) 294-5601

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rose Jeter's NPI number?

The NPI number for Rose Jeter is 1750742201. It was assigned to this individual provider in the NPPES registry on March 11, 2016.

Where is Rose Jeter located?

Rose Jeter practices at 115 S Sycamore St Suite B, Petersburg, VA 23803. The listed phone number is (804) 835-9511.

What is Rose Jeter's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Rose Jeter enrolled in Medicare?

No. Rose Jeter has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Rose Jeter was last updated on May 28, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.