Individual provider Active NPI

Virginia Ellen Defrancesh

  • Counselor
  • Greenville, SC
National Provider Identifier
1235460569
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
124 Mallard St.
Greenville, SC 29601-4046
Phone
(864) 241-1040
Fax
(864) 241-1215
NPI assigned
Jan 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

124 Mallard St.
Greenville, SC 29601-4046

Mailing address

124 Mallard St.
Greenville, SC 29601-4046
Phone (864) 241-1040

Other names 1

  • Virginia Ellen Bird Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 8, 2024 through Jul 8, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7313SCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1235460569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MALLARD ST.",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296014046",
            "telephone_number": "864-241-1040",
            "fax_number": "864-241-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MALLARD ST.",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296014046",
            "telephone_number": "864-241-1040",
            "fax_number": "864-241-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFRANCESH",
        "first_name": "VIRGINIA",
        "middle_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-27",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIRGINIA",
            "last_name": "BIRD",
            "middle_name": "ELLEN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.