Active NPI
Bethany Lackey, LPC
- Professional Counselor
- Roanoke, VA
National Provider Identifier
1427520188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701007503
- Practice address
- 1409 Grandin Rd SW
Roanoke, VA 24015-2317 - Phone
- (276) 224-2647
- NPI assigned
- Dec 19, 2018
- Last updated
- Mar 3, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701007503 | VA | Primary |
Addresses
Primary practice location
1409 Grandin Rd SW
Roanoke, VA 24015-2317
Mailing address
916B Winona Ave SW
Roanoke, VA 24015-5326
Phone (276) 224-2647
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701007503 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Tree Planted, Inc | Professional | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551571200000",
"number": "1427520188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "916B WINONA AVE SW",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240155326",
"telephone_number": "276-224-2647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 GRANDIN RD SW",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240152317",
"telephone_number": "276-224-2647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACKEY",
"first_name": "BETHANY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-19",
"last_updated": "2019-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701007503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, VA
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- Jeffrey L Lackore, PA
- Joanna Marie Lacroix
- Edward Ladyzhenskiy, M.D.
- Charles T Lafferty, DO
- Nitu Kaur Lahar
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.