Brandon R Bise, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

071006576 Issued in VA

Practice address

440 Fox Town Rd
Clintwood, VA 24228-5077

Phone

(276) 926-1680

Fax

(276) 926-9179

NPI assigned

Apr 12, 2016

Last updated

Apr 12, 2016By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1659735900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "CLINTWOOD",
            "state": "VA",
            "postal_code": "242280309",
            "telephone_number": "276-926-1680",
            "fax_number": "276-926-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 FOX TOWN RD",
            "city": "CLINTWOOD",
            "state": "VA",
            "postal_code": "242285077",
            "telephone_number": "276-926-1680",
            "fax_number": "276-926-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISE",
        "first_name": "BRANDON",
        "middle_name": "R",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-12",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "071006576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.