Blair Labudovich

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701011343 Issued in VA

Practice address

7025 Harbour View Blvd
Suffolk, VA 23435-2761

Phone

(757) 758-5106

NPI assigned

May 20, 2022

Sex

Female

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

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Western Tidewater Community Mental 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Western Tidewater Community Mental

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Suffolk, VA
  • NPI 1689615296

  VA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1679211635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4264 RALEIGH RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233213534",
            "telephone_number": "757-376-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7025 HARBOUR VIEW BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352761",
            "telephone_number": "757-758-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABUDOVICH",
        "first_name": "BLAIR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-20",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701011343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Suffolk, VA
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.