Individual provider Active NPI

Glenn N Scarboro, LCSW

  • Mental Health Counselor
  • Danville, VA
National Provider Identifier
1669578027
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0904001696 Issued in VA
Practice address
500 Piney Forest Rd
Suite C
Danville, VA 24540-3315
Phone
(434) 792-7437
Fax
(434) 792-7434
NPI assigned
Sep 15, 2006
Last updated
Jun 25, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0904001696 VA Primary

Addresses

Primary practice location

500 Piney Forest Rd
Suite C
Danville, VA 24540-3315

Mailing address

1045 Main Street, Suite 5
Counseling and Psychological Services, LLC
Danville, VA 24541-1800
Phone (434) 792-2277

Other identifiers 1

IdentifierTypeStateIssuer
010268907MedicaidVA

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
I20100503000235 VA Practitioner - Clinical Social Worker 1557497237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling and Psychological Services,LLCGroup PAC ID 3870751126, 6 clinicians

Practice addresses (Care Compare)

1045 Main St
Danville, VA 24541-1800
Phone (434) 792-2277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling and Psychological Services,LLC CurrentSince Dec 21, 2011 Accepting new patients

Locations

1045 Main St
Ste 5
Danville, VA 24541
Phone (434) 792-2277

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403654400000",
    "number": "1669578027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 MAIN STREET, SUITE 5",
            "address_2": "COUNSELING AND PSYCHOLOGICAL SERVICES, LLC",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411800",
            "telephone_number": "434-792-2277",
            "fax_number": "434-792-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PINEY FOREST RD",
            "address_2": "SUITE C",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245403315",
            "telephone_number": "434-792-7437",
            "fax_number": "434-792-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARBORO",
        "first_name": "GLENN",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2014-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0904001696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010268907",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.