Individual provider Active NPI

Sumara Wiggins, LPC, CRC

  • Mental Health Counselor
  • North Chesterfield, VA
National Provider Identifier
1003481771
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701010433 Issued in VA
Practice address
1905 Huguenot Rd Ste 306
North Chesterfield, VA 23235-4312
Phone
(804) 301-3424
Fax
(804) 800-2751
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0701010433 VA Primary

Addresses

Primary practice location

1905 Huguenot Rd Ste 306
North Chesterfield, VA 23235-4312

Mailing address

2806 Botone Ave
North Chesterfield, VA 23237-2068
Phone (804) 301-3424

Other practice location 1

107 S 5th St
Richmond, VA 23219-3825
Phone (804) 819-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240411004773 VA Practitioner - Mental Health Counselor 3072952936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sumara Wiggins LLC Mental Health CurrentSince Jan 27, 2024 Accepting new patients

Locations

1905 Huguenot Rd
Ste 306
North Chesterfield, VA 23235
Phone (804) 218-5649

1909 Huguenot Rd
North Chesterfield, VA 23235
Phone (804) 629-9028

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": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1003481771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2806 BOTONE AVE",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232372068",
            "telephone_number": "804-301-3424",
            "fax_number": "804-800-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 HUGUENOT RD STE 306",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354312",
            "telephone_number": "804-301-3424",
            "fax_number": "804-800-2751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 S 5th St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232193825",
            "country_code": "US",
            "telephone_number": "804-819-4000",
            "fax_number": "804-819-5221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "SUMARA",
        "name_prefix": "Ms.",
        "credential": "LPC, CRC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701010433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

Verify at the official NPI Registry.