Individual provider Active NPI

David Yasemsky, LPC

  • Professional Counselor
  • Chesapeake, VA
National Provider Identifier
1336214360
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701002229 Issued in VA
Practice address
2117 Smith Ave Ste B
Chesapeake, VA 23320-2519
Phone
(757) 547-9007
Fax
(757) 786-2805
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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 0701002229 VA Primary

Addresses

Primary practice location

2117 Smith Ave Ste B
Chesapeake, VA 23320-2519

Mailing address

2117 Smith Ave Ste B
Chesapeake, VA 23320-2519
Phone (757) 547-9007

Other identifiers 2

IdentifierTypeStateIssuer
010063434MedicaidVA
30016652470005MedicaidVA

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
I20240605000353 VA Practitioner - Mental Health Counselor 3870035900 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701002229VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Psychological Services Professional CurrentSince Apr 22, 2024 Accepting new patients

Locations

2117 Smith Ave
Ste B
Chesapeake, VA 23320
Phone (757) 547-9007

860 Greenbrier Cir
Ste 100
Chesapeake, VA 23320
Phone (757) 547-9007

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1336214360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 SMITH AVE STE B",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202519",
            "telephone_number": "757-547-9007",
            "fax_number": "757-786-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 SMITH AVE STE B",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202519",
            "telephone_number": "757-547-9007",
            "fax_number": "757-786-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASEMSKY",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701002229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010063434",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30016652470005",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.