Individual provider Active NPI

Lynessa Glass, LPC, LMFT

  • Professional Counselor
  • Virginia Beach, VA
National Provider Identifier
1922121904
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701002709 Issued in VA
Practice address
4356 Bonney Rd
Building 1, Ste 101
Virginia Beach, VA 23452-1200
Phone
(757) 717-0605
Fax
(757) 498-3311
NPI assigned
Apr 6, 2007
Last updated
Sep 30, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701002709 VA Primary
Marriage & Family Therapist 106H00000X 0717000634 VA

Addresses

Primary practice location

4356 Bonney Rd
Building 1, Ste 101
Virginia Beach, VA 23452-1200

Mailing address

4356 Bonney Rd
Building 1, Ste 101
Virginia Beach, VA 23452-1200
Phone (757) 717-0605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0701002709VAMDProfessional Counselor
0717000634VAMDMarriage & Family Therapist

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, 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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1922121904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4356 BONNEY RD",
            "address_2": "BUILDING 1, STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521200",
            "telephone_number": "757-717-0605",
            "fax_number": "757-498-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4356 BONNEY RD",
            "address_2": "BUILDING 1, STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521200",
            "telephone_number": "757-717-0605",
            "fax_number": "757-498-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "LYNESSA",
        "credential": "LPC, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701002709",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717000634",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.