Active NPI
Paul Bradley Fink, LPC
- Professional Counselor
- Virginia Beach, VA
National Provider Identifier
1629822937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701013466
- Practice address
- 2528 Las Brisas Dr
Virginia Beach, VA 23456-4264 - Phone
- (757) 689-0334
- Fax
- (757) 689-0350
- NPI assigned
- Apr 15, 2024
- Sex
- Male
- Sole proprietor
- No
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 | 0701013466 | VA | Primary |
Addresses
Primary practice location
2528 Las Brisas Dr
Virginia Beach, VA 23456-4264
Mailing address
3609 Kings Lake Dr
Virginia Beach, VA 23452-4656
Phone (757) 407-1842
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 |
|---|---|---|---|
| 0701013466 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reboot Functional Health Care Corporation | Current | Accepting new patients | |
| Beach Counseling, LLC | Professional | Current | Accepting new patients |
Locations
2528 Las Brisas Dr
Virginia Beach, VA 23456
Phone (757) 301-6985
Organizations & group practices 2
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.
-
- Psychiatric/Mental Health Clinical Nurse Specialist
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- NPI 1689162547
Professional
-
- Family Medicine Physician
- Virginia Beach, VA
- NPI 1427709526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713139200000",
"number": "1629822937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3609 KINGS LAKE DR",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234524656",
"telephone_number": "757-407-1842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2528 LAS BRISAS DR",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234564264",
"telephone_number": "757-689-0334",
"fax_number": "757-689-0350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FINK",
"first_name": "PAUL",
"middle_name": "BRADLEY",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-15",
"last_updated": "2024-04-15",
"certification_date": "2024-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701013466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.