REBECCA J CORNELL (NPI# 1073082962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1073082962 |
Entity Type | Individual |
Full Name | REBECCA J CORNELL |
Credential | LSATP, LCADC, CSAC |
Practice Address |
5477 Mooretown Rd Williamsburg VA 23188-2108 |
Mailing Address |
1240 W Ocean View Ave Apt 6 Norfolk VA 23503-1181 |
Practice Telephone | 7579416359 |
Mailing Telephone | 8595391451 |
Enumeration Date | 2018-11-20 |
Last Update Date | 2018-11-20 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
ADCLAD00225433 | KY | Behavioral Health & Social Service Providers |
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
0718000319 | VA | Behavioral Health & Social Service Providers |
N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
0710101660 | VA | Behavioral Health & Social Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
4460 Corporation Ln, Virginia Beach, VA 234623150 | 7574900377 |
Street Address |
5477 MOORETOWN RD |
City | WILLIAMSBURG |
State | VA |
Zip Code | 23188-2108 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215030549 | Krista Pine | Psychiatry & Neurology | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2006-09-05 |
1164905709 | Gary Lee Baker | Counselor | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2018-09-10 |
1679056535 | Justin Mangold | Counselor | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2018-09-07 |
1336621226 | Cynthia Betts | Social Worker | 5477 Mooretown Rd, Williamsburg, VA 23188 | 2018-09-06 |
1629576590 | Stephen Lynn Simmers | Counselor | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2018-01-25 |
1821503160 | Andreas Bienert | Counselor | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2017-12-08 |
1033544606 | Odessa Ochoa | Physician Assistant | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2013-09-13 |
1164703401 | Susan N Walkley | Nurse Practitioner | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2011-08-31 |
1861714404 | Van Aiken Deblieux | Counselor | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2010-02-24 |
1740450055 | Penelope Proctor Ziegler | Psychiatry & Neurology | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2008-03-04 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992287833 | Kathryn Goss Atanasov | Counselor | Farley Iop Williamsburg Place, 5477 Mooretown Road, Williamsburg, VA 23188 | 2018-09-06 |
1386180933 | Brittany Marie Purdy | Physical Therapist | 6425 Richmond Road, Williamsburg, VA 23188 | 2017-01-06 |
1770930745 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 6485 Centerville Rd, Williamsburg, VA 23188 | 2016-05-19 |
1073979738 | Sharon Harper | Social Worker | 4732 Longhill Road, Suite 3202, Williamsburg, VA 23188 | 2016-01-12 |
1710362819 | Diamond Healthcare | Social Worker | 5477 Mooretown Road, Williamsburg Place, Williamsburg, VA 23188 | 2015-07-30 |
1922489749 | Uc Davis Medical Center | General Acute Care Hospital | 3905 Cold Spring Rd, Williamsburg, VA 23188 | 2015-06-17 |
1013326214 | Deandra Smith | Developmental Therapist | 111 Bulifants Blvd Ste B, Williamsburg, VA 23188 | 2014-08-13 |
1255751590 | Lisa Marie Frazier | Counselor | 4345 New Town Ave. Ste. 107a, Williamsburg, VA 23188 | 2014-04-25 |
1972883569 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 7529 Richmond Rd, Williamsburg, VA 23188 | 2011-08-26 |
1720386816 | Harry Leon White | Pharmacist | 114 Molesey Hurst, Williamsburg, VA 23188 | 2011-03-14 |
Find all providers in zip 23188 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063035301 | Isobelle Morrison | Counselor | 705 Prosperity Ct, Williamsburg, VA 23188-3035 | 2020-05-21 |
1992287833 | Kathryn Goss Atanasov | Counselor | Farley Iop Williamsburg Place, 5477 Mooretown Road, Williamsburg, VA 23188 | 2018-09-06 |
1245601863 | Jordan Luck | Counselor | 372 Mclaws Cir Ste 1&2, Williamsburg, VA 23185-5636 | 2015-10-08 |
1528473956 | Khara J.b. Randall | Counselor | 1158 Professional Dr Ste N, Williamsburg, VA 23185-6618 | 2014-06-24 |
1467874099 | Pamela Kayanan | Counselor | 921 Capitol Landing Road, Colonial Behavioral Health, Williamsburg, VA 23185 | 2014-01-16 |
1114048808 | White Deer Run LLC | Counselor | Rr 1 Box 79, New Beginnings Road, Williamsburg, PA 16693-9673 | 2007-04-02 |
1144376112 | Bacon Street Youth and Family Services | Counselor | 247 Mclaws Circle, Williamsburg, VA 23185 | 2007-01-25 |
1740359926 | Eric Keith Hardison | Counselor | 1769 Jamestown Rd Ste 206, Williamsburg, VA 23185-2307 | 2006-11-06 |
1912960204 | Pamela Cappetta | Counselor | 362 Mclaws Cir, Suite 2, Williamsburg, VA 23185-5648 | 2006-04-08 |
1972591972 | Robert Eugene Coleman | Counselor | 1158 Professional Dr Ste M, Williamsburg, VA 23185-6618 | 2005-10-12 |
Find all providers in WILLIAMSBURG |
City | WILLIAMSBURG |
Zip Code | 23188 |
Please comment or provide details below to improve the information on REBECCA J CORNELL.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.