Individual provider Active NPI

Byron Earle Greenberg, PH.D., MPH

  • Clinical Psychologist
  • Colonial Heights, VA
National Provider Identifier
1891869087
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810002801 Issued in VA
Practice address
3628 Boulevard # B
Colonial Heights, VA 23834-1342
Phone
(804) 520-8688
Fax
(804) 597-0199
NPI assigned
Nov 20, 2006
Last updated
May 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810002801 VA Primary

Addresses

Primary practice location

3628 Boulevard # B
Colonial Heights, VA 23834-1342

Mailing address

3628 Boulevard # B
Colonial Heights, VA 23834-1342
Phone (804) 520-8668

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
I20180130000019 VA Practitioner - Clinical Psychologist 7113287897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3628 Boulevard
Suite B
Colonial Heights, VA 23834-1342
Phone (804) 520-6868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810002801VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenberg & Associates Clinical CurrentSince Mar 9, 2020 Accepting new patients
Associates in Counseling and Therapeutic Services LLC Past Accepting new patients

Locations

3628 Boulevard
#B
Colonial Heights, VA 23834
Phone (804) 520-6868

320B Charles H Dimmock Pkwy
Ste 5
Colonial Hgts, VA 23834
Phone (804) 524-2400

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1891869087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3628 BOULEVARD # B",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341342",
            "telephone_number": "804-520-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 BOULEVARD # B",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341342",
            "telephone_number": "804-520-8688",
            "fax_number": "804-597-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "BYRON",
        "middle_name": "EARLE",
        "name_prefix": "Dr.",
        "credential": "PH.D., MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

Verify at the official NPI Registry.