Bruce Charles Wyman, LPC, EDM, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701003919 Issued in VA

Practice address

10391 Greyson LN
Rixeyville, VA 22737-1730

Phone

(540) 937-4923

Fax

(540) 937-7680

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 4

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

State University of New York at Buffalo School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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.

• Evergreen Behavioral Health Services,LLC

  • Professional Counselor
  • Rixeyville, VA
  • NPI 1073879177

  Mental Health

  Medicare reassignment NPD Authorized official
• Mountain Laurel Group, LLC

  • Community/Behavioral Health Agency
  • Culpeper, VA
  • NPI 1124343801
  NPD (past) Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1821109331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 373",
            "city": "RIXEYVILLE",
            "state": "VA",
            "postal_code": "227370373",
            "telephone_number": "540-937-4923",
            "fax_number": "540-937-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10391 GREYSON LN",
            "city": "RIXEYVILLE",
            "state": "VA",
            "postal_code": "227371730",
            "telephone_number": "540-937-4923",
            "fax_number": "540-937-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYMAN",
        "first_name": "BRUCE",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "LPC, EDM, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701003919",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003919",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0701003919",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "VA",
            "license": "0701003919",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL",
            "identifier": "4435897",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECROSS BLUESHIELD",
            "identifier": "AS43-0001",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010375703",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11654016",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lotus Group Wellness, LLC
• Mta Medical Transport Assistance LLC Dbe
• Thomas Jay Neviaser, M.D.
• Piedmont Nutrition Associates, Inc.
• Kayla Lynn Wines

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.