Nacorya Waller, MSW, LMHP-S

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

123 Woodlyn Dr
Collinsville, VA 24078-1660

Phone

(276) 734-3415

Fax

(276) 209-3026

NPI assigned

Feb 6, 2023

Last updated

Apr 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Quality Connections Support Services LLC

  dba Quality Connections Support Services

  • Community/Behavioral Health Agency
  • Collinsville, VA
  • NPI 1194422881
  NPD Authorized official

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1831895309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 WOODLYN DR",
            "city": "COLLINSVILLE",
            "state": "VA",
            "postal_code": "240781660",
            "telephone_number": "276-734-3415",
            "fax_number": "276-209-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 WOODLYN DR",
            "city": "COLLINSVILLE",
            "state": "VA",
            "postal_code": "240781660",
            "telephone_number": "276-734-3415",
            "fax_number": "276-209-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "NACORYA",
        "credential": "MSW, LMHP-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-06",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Edward Unterbrink, OD
• Virginia CVS Pharmacy LLC (CVS Pharmacy # 05582)
• Walgreen Co (Walgreens # 12017)
• Richard Edwin Walker III
• Kurtasha D Waller
• Wally Betton OD LLC
• Marvin Stacy Wolfe
• Jaime Woodall
• Candace Marie Young, NP
• Zentmeyer Chiropractic PLLC

• Mental Health Counselor in Collinsville, VA
• Providers in Collinsville, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.