Individual provider Active NPI

Debra Clatterbuck

  • Professional Counselor
  • Harrisonburg, VA
National Provider Identifier
1760887665
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701005580 Issued in VA
Practice address
3270 Albert Long Dr
Harrisonburg, VA 22801-2472
Phone
(540) 432-8660
NPI assigned
Nov 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701005580 VA Primary
Community/Behavioral Health Agency 251S00000X 1691-05-001 VA

Addresses

Primary practice location

3270 Albert Long Dr
Harrisonburg, VA 22801-2472

Mailing address

3270 Albert Long Dr
Harrisonburg, VA 22801-2472
Phone (540) 432-8660

Other identifiers 2

IdentifierTypeStateIssuer
12657575OtherCAQH
1154602639MedicaidVA

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

LicenseStateTypeSpecialty
0701005580VAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1760887665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3270 ALBERT LONG DR",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228012472",
            "telephone_number": "540-432-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 ALBERT LONG DR",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228012472",
            "telephone_number": "540-432-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLATTERBUCK",
        "first_name": "DEBRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-04",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701005580",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "1691-05-001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12657575",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154602639",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.