Brainiac Neurofeedback Counseling and Coaching

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

BRAINIAC NEUROFEEDBACK COUNSELING AND COACHING

Practice address

9327 Ravensworth CT
Mechanicsville, VA 23116-8708

Phone

(804) 357-2483

NPI assigned

Feb 4, 2022

Last updated

Feb 4, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cheryl North DesvernineNPI 1881630317

Title

President

Phone

(804) 357-2483

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cheryl North Desvernine, LPC, MAC, SAP

  • Professional Counselor
  • Mechanicsville, VA
  • NPI 1881630317
  Medicare reassignment Care Compare group NPD Authorized official
• Kenneth Ashley Garland

  • Professional Counselor
  • Henrico, VA
  • NPI 1548039969
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643932800000",
    "number": "1710631205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9327 RAVENSWORTH CT",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231168708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9327 RAVENSWORTH CT",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231168708",
            "telephone_number": "804-357-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAINIAC NEUROFEEDBACK COUNSELING AND COACHING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "DESVERNINE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "NORTH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-357-2483"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "0701002731",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann Boykin, COTA/L
• John P Boyle, DDS
• Kimberly Beth Boyle, DDS
• Daniel Bradley
• Robert J Brager, MD
• James Braith, PHD, LCP
• Brandon M Schafer PLLC
• Japtejvir Singh Brar, CRNA
• Sara Braswell, MD
• Philip M Breidenbaugh, P.T.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.