NPIMap

Organization Active NPI

Breyta Psychological Services, P.a.

  • Psychologist
  • Raleigh, NC
National Provider Identifier
1871076406
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
BREYTA PSYCHOLOGICAL SERVICES, P.A.
Practice address
8303 Six Forks Rd Ste 207
Raleigh, NC 27615-3094
Phone
(919) 245-7791
Fax
(919) 867-2786
NPI assigned
Sep 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Authorized official

Name
Dr. Vanessa Handsel Roddenberry, PHDNPI 1780029488
Title
Owner
Phone
(919) 245-7791

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

8303 Six Forks Rd Ste 207
Raleigh, NC 27615-3094

Mailing address

8303 Six Forks Rd Ste 207
Raleigh, NC 27615-3094
Phone (919) 245-7791

National Provider Directory

National Provider Directory

Locations

8303 Six Forks Rd
Ste 207
Raleigh, NC 27615
Phone (919) 245-7791

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1871076406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8303 SIX FORKS RD STE 207",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153094",
            "telephone_number": "919-245-7791",
            "fax_number": "919-867-2786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 SIX FORKS RD STE 207",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153094",
            "telephone_number": "919-245-7791",
            "fax_number": "919-867-2786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREYTA PSYCHOLOGICAL SERVICES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-10",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "RODDENBERRY",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_middle_name": "HANDSEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-245-7791",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.