Makayla Bing
Individual provider Active NPI Professional Counselor · Boydton, VA
NPI 1699490409 · NPPES record last updated Oct 5, 2022
Key facts
- NPI
- 1699490409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 0701011807 (VA)
- Practice address
- 450 Washington St.
Boydton, VA 23917-2391 - Phone
- (434) 738-0406
- NPI assigned
- Oct 5, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240206003718 | VA | Practitioner - Mental Health Counselor | 1355784315 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southside Behavioral Health | Current |
Accepting new patients |
Locations
424 Hamilton Blvd
South Boston, VA 24592
Phone (434) 572-2936
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701011807 | VA | Yes |
Addresses
Primary practice location
450 Washington St.
Boydton, VA 23917-2391
Mailing address
PO Box 350
Boydton, VA 23917-0350
Phone (434) 738-0406
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0701011807 | Other | VA | VIRGINIA BOARD OF COUNSELING |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mhudson@southsidebh.org | Health Information Exchange (HIE) | Southside Behavioral Health |
Other providers in Boydton, VA
- Melinda Baskerville
- Rakita Baskerville
- Best Solutions Counseling Services LLC
- Boydton Community Health Facility Inc
- Boydton Community Health Facility Inc
- Boydton Community Health Facility, Inc
- Boydton Community Health Facility, Inc.
- Boydton Community Pharmacy
All providers in Boydton, VA · Professional Counselor in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.