Active NPI
Nicole Kornbluh, LPC
- Counselor
- Chesapeake, VA
National Provider Identifier
1720561202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- PC015720
- Practice address
- 1010 Annabranch Trce
Chesapeake, VA 23323-5755 - Phone
- (757) 284-1938
- NPI assigned
- Sep 11, 2018
- Last updated
- May 23, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | PC015720 | PA | Primary |
Addresses
Primary practice location
1010 Annabranch Trce
Chesapeake, VA 23323-5755
Mailing address
1010 Annabranch Trce
Chesapeake, VA 23323-5755
Phone (757) 284-1938
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC015720 | PA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milestone Centers Inc. | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/milestonepa/r4/
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.
-
- Community/Behavioral Health Agency
- Pittsburgh, PA
- NPI 1841218757
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1720561202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 ANNABRANCH TRCE",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233235755",
"telephone_number": "757-284-1938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 ANNABRANCH TRCE",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233235755",
"telephone_number": "757-284-1938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORNBLUH",
"first_name": "NICOLE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-11",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "PA",
"license": "PC015720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.