Segunda Yanez Acosta, PH.D., A.P.R.N.,B.C.

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

0015000200 Issued in VA

Practice address

10529 Crestwood Dr.
Suite 101
Manassas, VA 20109-4418

Phone

(703) 392-6420

Fax

(703) 392-6421

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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.

• Stress Centre, Inc.

  • Mental Health Counselor
  • Manassas, VA
  • NPI 1538408364
  NPD (past) Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225147341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JEFFERSON DAVIS HWY",
            "address_2": "SUITE 101",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014436",
            "telephone_number": "540-373-6420",
            "fax_number": "540-373-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10529 CRESTWOOD DR.",
            "address_2": "SUITE 101",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201094418",
            "telephone_number": "703-392-6420",
            "fax_number": "703-392-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "SEGUNDA",
        "middle_name": "YANEZ",
        "name_prefix": "Dr.",
        "credential": "PH.D., A.P.R.N.,B.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0015000200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS MANASSAS OFFI",
            "identifier": "145346",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5487014",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS FREDERICKSBUR",
            "identifier": "057433",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST",
            "identifier": "H1670001",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "324116",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Manassas, VA
• Psychiatric/Mental Health Clinical Nurse Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.