Lynessa Glass, Inc.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701002709 Issued in VA

Legal business name

LYNESSA GLASS, INC.

Practice address

4356 Bonney Rd
Building 1, Suite 101
Virginia Beach, VA 23452-1200

Phone

(757) 717-0605

Fax

(757) 498-3311

NPI assigned

Apr 9, 2007

Organization subpart

No

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

Authorized official

Name

Lynessa Glass, LPC LMFT

Title

Director

Phone

(757) 717-0605

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1366565954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4356 BONNEY RD",
            "address_2": "BUILDING 1, SUITE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521200",
            "telephone_number": "757-717-0605",
            "fax_number": "757-498-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4356 BONNEY RD",
            "address_2": "BUILDING 1, SUITE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521200",
            "telephone_number": "757-717-0605",
            "fax_number": "757-498-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNESSA GLASS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "GLASS",
        "authorized_official_first_name": "LYNESSA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "757-717-0605",
        "authorized_official_credential": "LPC LMFT"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701002709",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717000634",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.