Individual provider Active NPI

Rebecca E. Glass, LPC, LMFT

  • Professional Counselor
  • Newport News, VA
National Provider Identifier
1164529152
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701003963 Issued in VA
Practice address
707 Gum Rock CT
Newport News, VA 23606
Phone
(757) 873-2273
Fax
(757) 873-9422
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701003963 VA Primary

Addresses

Primary practice location

707 Gum Rock CT
Newport News, VA 23606

Mailing address

PO Box 2546
Virginia Beach, VA 23450-2546
Phone (757) 340-3489

Other identifiers 1

IdentifierTypeStateIssuer
1164529152MedicaidVA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240226000248 VA Practitioner - Mental Health Counselor 3577993542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peninsula Pastoral Counseling Center IncGroup PAC ID 2668802638, 7 clinicians

Practice addresses (Care Compare)

707 Gum Rock CT
Newport News, VA 23606-2523
Phone (757) 873-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701003963VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Pastoral Counseling Center Inc. Professional CurrentSince Sep 14, 2006 Accepting new patients

Locations

707 Gum Rock Ct
Newport News, VA 23606
Phone (757) 873-2273

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1164529152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2546",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234502546",
            "telephone_number": "757-340-3489",
            "fax_number": "757-340-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 GUM ROCK CT",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23606",
            "telephone_number": "757-873-2273",
            "fax_number": "757-873-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "REBECCA",
        "middle_name": "E.",
        "credential": "LPC, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164529152",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.