NPIMap

Organization Active NPI

Southwestern Virginia Counseling and Psychological Services

  • Clinical Psychologist
  • Wytheville, VA
National Provider Identifier
1083799597
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
SOUTHWESTERN VIRGINIA COUNSELING AND PSYCHOLOGICAL SERVICES
Practice address
1035 W Main St Ste a
Wytheville, VA 24382-2106
Phone
(276) 228-6900
Fax
(276) 228-6910
NPI assigned
Oct 25, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert W Smith, PH.D.
Title
Owner
Phone
(276) 228-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

1035 W Main St Ste a
Wytheville, VA 24382-2106

Mailing address

1035 W Main St Ste a
Wytheville, VA 24382-2106
Phone (276) 228-6900

Other identifiers 2

IdentifierTypeStateIssuer
179565OtherVAANTHEM PROVIDER LEGACY
179557OtherVAANTHEM PROVIDER LEGACY

National Provider Directory

National Provider Directory

Locations

1035 W Main St
Ste A
Wytheville, VA 24382
Phone (276) 228-6900

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083799597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 W MAIN ST STE A",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243822106",
            "telephone_number": "276-228-6900",
            "fax_number": "276-228-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 W MAIN ST STE A",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243822106",
            "telephone_number": "276-228-6900",
            "fax_number": "276-228-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN VIRGINIA COUNSELING AND PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-228-6900",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER LEGACY",
            "identifier": "179565",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER LEGACY",
            "identifier": "179557",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wytheville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.