NPIMap

Organization Active NPI

Individualized Counseling of Roanoke LLC

  • Clinical Social Worker
  • Roanoke, VA
National Provider Identifier
1891169819
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904005798 Issued in VA
Legal business name
INDIVIDUALIZED COUNSELING OF ROANOKE LLC
Practice address
3524 Brambleton Ave Ste 5
Roanoke, VA 24018-6528
Phone
(540) 776-6466
NPI assigned
Nov 16, 2015
Last updated
Nov 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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

Authorized official

Name
Mrs. Teresa Misco, LCSWNPI 1801812557
Title
Sole Member
Phone
(540) 776-6466

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904005798 VA Primary

Addresses

Primary practice location

3524 Brambleton Ave Ste 5
Roanoke, VA 24018-6528

Mailing address

3524 Brambleton Ave Ste 5
Roanoke, VA 24018-6528
Phone (540) 776-6466

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447632000000",
    "number": "1891169819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3524 BRAMBLETON AVE STE 5",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240186528",
            "telephone_number": "540-776-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3524 BRAMBLETON AVE STE 5",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240186528",
            "telephone_number": "540-776-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUALIZED COUNSELING OF ROANOKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-16",
        "last_updated": "2015-11-16",
        "status": "A",
        "authorized_official_last_name": "MISCO",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "540-776-6466",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; 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.