Rebecca Maxine Wyatt, CADC, CCJP, CSC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

704151 Issued in VA

Practice address

4 S Market St
Petersburg, VA 23803-4216

Phone

(804) 691-6144

NPI assigned

Jun 7, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1902190986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 S MARKET ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238034216",
            "telephone_number": "804-691-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 S MARKET ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238034216",
            "telephone_number": "804-691-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "REBECCA",
        "middle_name": "MAXINE",
        "credential": "CADC, CCJP, CSC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "704151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latrice Winston III, LPC
• Jazmine Camille Wood
• Jennifer Wood, FNP-BC
• Imoni Malika Patrice Woodberry, LPC
• Altamarie Woods
• Brenda C Wyche, LPC
• Xiao Hong Jin MD PLLC
• Fontellia Yates, RPH
• Sujatha Yellinedi, M.D.
• Ferley Terrell Yerby

• Addiction (Substance Use Disorder) Counselor in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Addiction (Substance Use Disorder) Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.