Individual provider Active NPI

Shanequa Martine Vass

  • Mental Health Counselor
  • Chesapeake, VA
National Provider Identifier
1861204737
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701014218 Issued in VA
Practice address
4037 Taylor Rd Ste D
Chesapeake, VA 23321-5500
Phone
(757) 512-7212
NPI assigned
Jan 27, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0701014218 VA Primary

Addresses

Primary practice location

4037 Taylor Rd Ste D
Chesapeake, VA 23321-5500

Mailing address

3121 Hull St
Portsmouth, VA 23704-6133
Phone (757) 537-4820

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
0701014218VAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1861204737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 HULL ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237046133",
            "telephone_number": "757-537-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4037 TAYLOR RD STE D",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215500",
            "telephone_number": "757-512-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASS",
        "first_name": "SHANEQUA",
        "middle_name": "MARTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701014218",
            "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 Feb 4, 2025; 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.