NPIMap

Organization Active NPI

Breakforth Counseling and Consulting LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Roanoke, VA
National Provider Identifier
1609490960
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BREAKFORTH COUNSELING AND CONSULTING LLC
Practice address
3959 Electric Rd Ste 425
Roanoke, VA 24018-4563
Phone
(540) 556-4356
Fax
(540) 266-7511
NPI assigned
Jun 2, 2020
Last updated
Jun 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Authorized official

Name
Dr. Gilbert Todd Vance, PHDNPI 1063534683
Title
Clinical Psychologist/Owner
Phone
(540) 556-4356

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3959 Electric Rd Ste 425
Roanoke, VA 24018-4563

Mailing address

3959 Electric Rd Ste 425
Roanoke, VA 24018-4563
Phone (540) 556-4356

National Provider Directory

National Provider Directory

Locations

3959 Electric Rd
Ste 425
Roanoke, VA 24018
Phone (540) 206-2385

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591056000000",
    "number": "1609490960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 ELECTRIC RD STE 425",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184563",
            "telephone_number": "540-556-4356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 ELECTRIC RD STE 425",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184563",
            "telephone_number": "540-556-4356",
            "fax_number": "540-266-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKFORTH COUNSELING AND CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A",
        "authorized_official_last_name": "VANCE",
        "authorized_official_first_name": "GILBERT",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "540-556-4356",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; 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.