Individual provider Active NPI

Cheryl North Desvernine, LPC, MAC, SAP

  • Professional Counselor
  • Mechanicsville, VA
National Provider Identifier
1881630317
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701002731 Issued in VA
Practice address
9327 Ravensworth CT
Mechanicsville, VA 23116-8708
Phone
(804) 357-2486
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701002731 VA Primary

Addresses

Primary practice location

9327 Ravensworth CT
Mechanicsville, VA 23116-8708

Mailing address

9327 Ravensworth CT
Mechanicsville, VA 23116-8708
Phone (804) 357-2486

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240404002674 VA Practitioner - Mental Health Counselor 4385082718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brainiac Neurofeedback Counseling and CoachingGroup PAC ID 9830537265, 2 clinicians

Practice addresses (Care Compare)

3932 Springfield Rd
Glen Allen, VA 23060-4119
Phone (804) 250-3450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701002731VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brainiac Neurofeedback Counseling and Coaching Professional CurrentSince Jul 19, 2019 Accepting new patients

Locations

3932 Springfield Rd
Glen Allen, VA 23060
Phone (804) 747-8300

2807 N Parham Rd
Ste 140
Henrico, VA 23294
Phone (804) 878-9716

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1881630317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9327 RAVENSWORTH CT",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231168708",
            "telephone_number": "804-357-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9327 RAVENSWORTH CT",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231168708",
            "telephone_number": "804-357-2486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESVERNINE",
        "first_name": "CHERYL",
        "middle_name": "NORTH",
        "name_prefix": "Mrs.",
        "credential": "LPC, MAC, SAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701002731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

Verify at the official NPI Registry.