Southwest Regional Counseling Service Inc

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

SOUTHWEST REGIONAL COUNSELING SERVICE INC

Practice address

1114 E Main St Ste 4
Lebanon, VA 24266-5014

Phone

(276) 883-5050

Fax

(276) 883-5998

NPI assigned

May 16, 2019

Last updated

May 16, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Joshua Lipford

Title

Manager

Phone

(423) 895-8266

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tina Lucille Henderson, PMHNP-BC

  • Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
  • Richlands, VA
  • NPI 1831745611
  Medicare reassignment Care Compare group NPD
• Dan Adrian Nicolau, M.D.

  • Psychiatry Physician
  • Mountain Home, TN
  • NPI 1992098396

  VA

  Medicare reassignment Care Compare group NPD
• Tony Yost, MD

  • Family Medicine Physician
  • Mosheim, TN
  • NPI 1003858796

  VA

  Medicare reassignment Care Compare group NPD
• Douglas David Dalton II, PA-C

  • Physician Assistant
  • Abingdon, VA
  • NPI 1255300109
  Medicare reassignment Care Compare group
• Amy Lee Carpenter, FNP-BC

  • Family Nurse Practitioner
  • Abingdon, VA
  • NPI 1437688116
  Medicare reassignment NPD
• Jennifer Denise Combs, LPC

  • Professional Counselor
  • Lebanon, VA
  • NPI 1801574074

  Single Specialty

  Medicare reassignment NPD
• Sasha Musick, FNP-C

  • Family Nurse Practitioner
  • Lebanon, VA
  • NPI 1306376108
  Medicare reassignment NPD
• Andrew Nathan Brown, MD

  • Family Medicine Physician
  • Rogersville, TN
  • NPI 1558562850

  VA

  Medicare reassignment NPD
• Pyung Suh, M.D.

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1295779148

  VA

  Medicare reassignment NPD
• Christopher Howell, M.D., PA-C

  • Physician Assistant
  • Blacksburg, VA
  • NPI 1437419132
  Medicare reassignment

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1063078855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242660306",
            "telephone_number": "273-883-5050",
            "fax_number": "276-883-5998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 E MAIN ST STE 4",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242665014",
            "telephone_number": "276-883-5050",
            "fax_number": "276-883-5998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST REGIONAL COUNSELING SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-16",
        "last_updated": "2019-05-16",
        "status": "A",
        "authorized_official_last_name": "LIPFORD",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "423-895-8266",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cora Grace Shelton, FNP
• Lorin Elise Shortt, MA, CCC-SLP
• Tyler Skeen
• Kelly Elizabeth Smith, LCSW, CSAC
• Samuel Smith, PT, DPT
• Vanessa Stacy
• Charles Seth Stanley, PT, DPT
• Steve Ball DDS PC
• Mandy Stiltner, RPH
• Jessica Stone, MS, CCC-SLP

• Addiction (Substance Use Disorder) Counselor in Lebanon, VA
• Providers in Lebanon, VA by specialty
• Addiction (Substance Use Disorder) Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.