Lerese A Deberry, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701007692 Issued in VA

Practice address

10900 Nuckols Rd Ste 100
Glen Allen, VA 23060-9277

Phone

(804) 207-6737

NPI assigned

Jun 5, 2019

Last updated

Nov 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Lerese Adreinne Deberry Professional name

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aevum BH VA LLC

  dba Aevum Behavioral Health

  • General Practice Physician
  • Richmond, VA
  • NPI 1225856008
  Medicare reassignment NPD
• Virginia Center for Addiction Medicine

  dba Master Center for Addiction Medicine

  • Addiction Medicine (Internal Medicine) Physician
  • Glen Allen, VA
  • NPI 1477091247
  Medicare reassignment NPD
• Aevum Behavioral Health VA LLC

  dba Aevum Behavioral Health

  • Mental Health Counselor
  • Richmond, VA
  • NPI 1104650985
  NPD (past)

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1124686050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 NUCKOLS RD STE 100",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609277",
            "telephone_number": "804-207-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 NUCKOLS RD STE 100",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609277",
            "telephone_number": "804-207-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBERRY",
        "first_name": "LERESE",
        "middle_name": "A",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701007692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LERESE",
            "last_name": "DEBERRY",
            "middle_name": "ADREINNE",
            "prefix": "MS.",
            "credential": "LPC, 06/13/2018",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Michael Wayne Davis, LCSW
• Misty Davis, M S
• Tanya L Davis
• Patricia Daylor
• Thomas D Dayspring, MD, FACP
• Erin M Deibel, AGACNP-BC
• Megan Elizabeth Deibel
• Samantha Megan Zehnle Del Campo, OD
• Gregory F Delano Jr., PT, DPT
• Campbell Shell Delk, DDS

• Professional Counselor in Glen Allen, VA
• Providers in Glen Allen, 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 20, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.