Individual provider Active NPI

Brenda Lea Tebay, M.A.

  • Psychologist
  • Parkersburg, WV
National Provider Identifier
1003905464
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
WV 878 Issued in WV
Practice address
1200 Stephenson Ave Ste 400
Parkersburg, WV 26101-4889
Phone
(304) 699-0506
Fax
(304) 422-8850
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X WV 878 WV Primary

Addresses

Primary practice location

1200 Stephenson Ave Ste 400
Parkersburg, WV 26101-4889

Mailing address

PO Box 373
Harrisville, WV 26362-0373
Phone (304) 643-4005

Other identifiers 1

IdentifierTypeStateIssuer
3810000161MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
WV 878WVMDPsychologist

Interoperability endpoints

  • Direct secure messaging: b.tebay@ritchieregional.directbygreenway.com

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1003905464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 373",
            "city": "HARRISVILLE",
            "state": "WV",
            "postal_code": "263620373",
            "telephone_number": "304-643-4005",
            "fax_number": "304-643-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 STEPHENSON AVE STE 400",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261014889",
            "telephone_number": "304-699-0506",
            "fax_number": "304-422-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEBAY",
        "first_name": "BRENDA",
        "middle_name": "LEA",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": "WV 878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000161",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

Verify at the official NPI Registry.