Crystal Somerville
Individual provider Active NPI Professional Counselor · Rustburg, VA
NPI 1972018190 · NPPES record last updated Dec 11, 2017
Key facts
- NPI
- 1972018190
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 0701007384 (VA)
- Practice address
- 37 Village Hwy
Rustburg, VA 24588-4112 - Phone
- (434) 332-5159
- NPI assigned
- Dec 11, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Thrive Counseling LLC
Practice addresses (Care Compare)
1015 Chestnut St
Suite 1520
Philadelphia, PA 19107-4315
Phone (855) 284-7483
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231212002999 | PA | Practitioner - Mental Health Counselor | 9335598630 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701007384 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Counseling LLC | Current |
Accepting new patients | |
| St. Luke'S Physician Group, Inc. | Current |
Accepting new patients | |
| St Luke'S Physician Group Inc | Current |
Accepting new patients | |
| St. Luke'S Physician Group, Inc. | Current | Accepting new patients | |
| Horizon Behavioral Health | Past |
Accepting new patients | |
| Horizon Behavioral Health | Past | Accepting new patients |
Locations
801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200
1015 Chestnut St
Ste 1520
Philadelphia, PA 19107
Phone (215) 601-7379
5830 Ellsworth Ave
Ste 301
Pittsburgh, PA 15232
Phone (412) 208-6279
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701007384 | VA | Yes |
Addresses
Primary practice location
37 Village Hwy
Rustburg, VA 24588-4112
Mailing address
3410 Old Forest Rd
Lynchburg, VA 24501-2915
Other providers in Rustburg, VA
- Rachel G Ripley
- Laurel Samko
- Melanie Sexton
- Gertrude K Shahady
- Jorena Simpkins
- Chris Wayne Stevens
- Joseph Strasshofer
- Alexandra M Sullivan
- Kenneth Swanson
- Thomas Aaron Tascone
All providers in Rustburg, VA · Professional Counselor in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.