Hal Irwin Imburg, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701003786 Issued in VA

Practice address

4825 S Laburnum Ave
Richmond, VA 23231-2713

Phone

(804) 222-2607

Fax

(804) 236-9118

NPI assigned

Feb 15, 2007

Last updated

Jan 9, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Richmond Creative Counseling

  dba Wild Oaks

  • Adult Mental Health Clinic/Center
  • North Chesterfield, VA
  • NPI 1285322628
  NPD (past)
• Richmond Creative Counseling, LLC

  • Professional Counselor
  • Richmond, VA
  • NPI 1689016735
  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1568505923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10299 WOODMAN RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230604419",
            "telephone_number": "804-727-8500",
            "fax_number": "804-727-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 S LABURNUM AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232312713",
            "telephone_number": "804-222-2607",
            "fax_number": "804-236-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMBURG",
        "first_name": "HAL",
        "middle_name": "IRWIN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710001240",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER",
            "identifier": "4945131",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "083948M",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Imagination LLC
• Daisuke Imai, MD
• Kimberly M Imajo, AU.D.
• Imani Healthcare Services Inc.
• Terence Alfred Imbery, D.D.S
• Immediate MD, PLLC
• Impact Life Residential Care
• Impact on Youth Services, LLC
• Impact Youth Services, LLC
• Improve ABA of VA LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; 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.