Individual provider Active NPI

Lena Villanueva, PMHNP-BC

  • Nurse Practitioner
  • Norfolk, VA
National Provider Identifier
1912617812
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024185651 Issued in VA
Practice address
6160 Kempsville Cir Ste 325a
Norfolk, VA 23502-3933
Phone
(757) 354-2885
Fax
(757) 917-5141
NPI assigned
Dec 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024185651 VA
Nurse Practitioner 363L00000X 0024185651 VA Primary

Addresses

Primary practice location

6160 Kempsville Cir Ste 325a
Norfolk, VA 23502-3933

Mailing address

6160 Kempsville Cir Ste 325a
Norfolk, VA 23502-3933
Phone (757) 354-2885

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230118001833 VA Practitioner - Nurse Practitioner 0143691741 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SE Virginia Value Based Care LLCGroup PAC ID 6103288170, 160 clinicians
Mid Atlantic Long Term Specialty Care LLCGroup PAC ID 8921427162, 28 clinicians

Practice addresses (Care Compare)

Norfolk, VA 23502
Phone (757) 354-2885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024185651VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SE Virginia Value Based Care, LLC CurrentSince Aug 1, 2023 Accepting new patients
Mid Atlantic Long Term Specialty Care LLC Nurse Practitioner CurrentSince Jan 1, 2023 Accepting new patients
Ict Services, Inc. Psychiatric/Mental Health CurrentSince Aug 1, 2024 Accepting new patients

Locations

6160 Kempsville Cir
Ste 325A
Norfolk, VA 23502
Phone (757) 354-2885

6465 College Park Sq
Ste 300
Virginia Beach, VA 23464
Phone (757) 351-0057

Organizations & group practices 3

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": "1669852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1912617812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 KEMPSVILLE CIR STE 325A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023933",
            "telephone_number": "757-354-2885",
            "fax_number": "757-917-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 KEMPSVILLE CIR STE 325A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023933",
            "telephone_number": "757-354-2885",
            "fax_number": "757-917-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "LENA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-01",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024185651",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024185651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.