Redefine Therapy, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

REDEFINE THERAPY, LLC

Practice address

1216 Granby St Ste 211
Norfolk, VA 23510-2622

Phone

(757) 632-0343

Fax

(757) 974-9374

NPI assigned

Feb 6, 2023

Organization subpart

No

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

Authorized official

Name

Mr. John L Stacy, LPC,CSACNPI 1306182795

Title

Owner/Therapist

Phone

(757) 632-0343

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Leroy Stacy Jr., CSAC, LPC

  • Professional Counselor
  • Norfolk, VA
  • NPI 1306182795
  Medicare reassignment NPD Authorized official
• Melinda June Meyers, LPC, ATR

  • Mental Health Counselor
  • Norfolk, VA
  • NPI 1477180065
  Medicare reassignment NPD
• Elizabeth Ruth Wieschhaus

  • Professional Counselor
  • Norfolk, VA
  • NPI 1750891263
  Medicare reassignment NPD

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1245936616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 GRANBY ST STE 211",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235102622",
            "telephone_number": "757-632-0343",
            "fax_number": "757-974-9374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 GRANBY ST STE 211",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235102622",
            "telephone_number": "757-632-0343",
            "fax_number": "757-974-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDEFINE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-06",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "STACY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "757-632-0343",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC,CSAC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306182795",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Recovery Trek, LLC
• Anne D Redding, M.D.
• Crysta Reddock
• Nicole Marie Reddout, DMD
• Rohit Yalla Reddy, MD
• Redesigning Mental Health Services LLC
• Ashley Mason Reed, M.D.
• Caitlin Brook Reed
• Ebony D Reed, DMD, MS
• Faye P. Reed, L.C.S.W., C.S.A.C

• Professional Counselor in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.