Individual provider Active NPI

Bryce Edwin Lefever, PH.D. ABPP

  • Clinical Psychologist
  • Charleston, WV
National Provider Identifier
1205800620
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
081003119 Issued in VA
Practice address
5400 Big Tyler Rd # D
Charleston, WV 25313-1178
Phone
(717) 848-6116
Fax
(717) 852-7580
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 081003119 VA Primary

Addresses

Primary practice location

5400 Big Tyler Rd # D
Charleston, WV 25313-1178

Mailing address

PO Box 1595
Middletown, CT 06457-8095
Phone (717) 272-5464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, PA, ME3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200701003040 WV Practitioner - Clinical Psychologist 6204259625 Reassigns benefits to 1 organization
I20210107002202 PA Practitioner - Clinical Psychologist 6204259625 Reassigns benefits to 1 organization
I20220728001382 ME Practitioner - Clinical Psychologist 6204259625 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1260WVMDMental Health Counselor
081003119VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Meditelecare of Pennsylvania LLC Clinical CurrentSince Dec 5, 2020 Accepting new patients
Meditelecare of West Virginia PLLC Clinical CurrentSince Jun 1, 2020 Accepting new patients
Medoptions of Maine, LLC Clinical CurrentSince Mar 1, 2021 Accepting new patients

Locations

23 Cedar Ridge Dr
Skowhegan, ME 04976
Phone (207) 474-9686

7 Highwood St
Waterville, ME 04901
Phone (207) 873-0705

600 N 2nd St
Ste 401
Harrisburg, PA 17101
Phone (844) 341-2339

400 Fairview Heights Rd
Summersville, WV 26651
Phone (304) 872-2891

Organizations & group practices 3

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1205800620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1595",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064578095",
            "telephone_number": "717-272-5464",
            "fax_number": "717-273-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 BIG TYLER RD # D",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253131178",
            "telephone_number": "717-848-6116",
            "fax_number": "717-852-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEFEVER",
        "first_name": "BRYCE",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "PH.D. ABPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "081003119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.