Wanda A. Crockett, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

07010000950 Issued in VA

Practice address

2006 Bremo Rd
Suite 101
Richmond, VA 23226-2438

Phone

(804) 288-1881

Fax

(804) 288-1881

NPI assigned

Sep 30, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Insight Physicians PCGroup PAC ID 2860394178, 28 clinicians

Psych Associates of Maryland LLCGroup PAC ID 3971550963, 151 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Insight Physicians PC

  • Psychiatry Physician
  • Richmond, VA
  • NPI 1801817150
  Medicare reassignment Care Compare group NPD
• Psych Associates of Maryland LLC

  dba Bloom Health Centers

  • Psychologist
  • Timonium, MD
  • NPI 1891721981

  DC, VA

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226966400000",
    "number": "1003803578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 BREMO RD",
            "address_2": "SUITE 101",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262438",
            "telephone_number": "804-288-1881",
            "fax_number": "804-288-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 BREMO RD",
            "address_2": "SUITE 101",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262438",
            "telephone_number": "804-288-1881",
            "fax_number": "804-288-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "WANDA",
        "middle_name": "A.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2008-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "07010000950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005401895",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crisscare Services, LLC
• Alberto Cristobal, MD
• Critical Care Systems Inc.
• Christopher Critzer, C.R.N.A
• Brighton Elizabeth Croce, MSW
• Elizabeth Jody Crognale, M.D.
• Nikida Cromartie-James, MSW
• Brian Reed Cromer, PA-C
• Danakristal Crone
• Olivia Ann Cronk

• Professional Counselor in Richmond, VA
• Providers in Richmond, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.