Individual provider Active NPI

Ladonna Larnice Devane-Perry, LPC, NCC

  • Professional Counselor
  • Suffolk, VA
National Provider Identifier
1629805288
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701013967 Issued in VA
Practice address
707 Gittings St Ste 120
Suffolk, VA 23434-6101
Phone
(757) 514-3248
NPI assigned
Sep 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 0701013967 VA
Professional Counselor 101YP2500X 0701013967 VA Primary

Addresses

Primary practice location

707 Gittings St Ste 120
Suffolk, VA 23434-6101

Mailing address

1201 Plexor LN
Knightdale, NC 27545-7279
Phone (910) 632-4580

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
I20250205000997 VA Practitioner - Mental Health Counselor 0941730089 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Family Services CurrentSince Sep 16, 2024 Accepting new patients
Wishing Well Counseling Center, PLLC CurrentSince Sep 23, 2024 Accepting new patients
Wishing Well Mental Health Services, LLC CurrentSince Sep 23, 2024 Accepting new patients

Locations

4037 Taylor Rd
Ste A
Chesapeake, VA 23321
Phone (757) 483-1403

115 W 2nd Ave
Franklin, VA 23851
Phone (757) 562-1000

707 Gittings St
Ste 120
Suffolk, VA 23434
Phone (757) 514-3248

Organizations & group practices 3

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": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1629805288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 PLEXOR LN",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457279",
            "telephone_number": "910-632-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 GITTINGS ST STE 120",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234346101",
            "telephone_number": "757-514-3248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVANE-PERRY",
        "first_name": "LADONNA",
        "middle_name": "LARNICE",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "VA",
            "license": "0701013967",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701013967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.