DR. ANTHONY H BRUDER (NPI# 1972588994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972588994 |
| Entity Type | Individual |
| Full Name | DR. ANTHONY H BRUDER |
| Credential | LMFT LPC PHD |
| Practice Address |
289 Independence Blvd Pembroke 3 Ste 221 Virginia Beach VA 23462-5493 |
| Practice Telephone | 7574989320 |
| Practice Fax Number | 7574989321 |
| Mailing Telephone | 7574989320 |
| Mailing Fax Number | 7574989321 |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101Y00000X | Counselor | 0701000704 | VA | Behavioral Health & Social Service Providers |
| X | 106H00000X | Marriage & Family Therapist | 0717000666 | VA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | CIGNA | 7577052 | 01 |
| VA | COMPSYCH | 148812 | 01 |
| VA | ANTHEM | 064518 | 01 |
| VA | COMPSYCH | 149635 | 01 |
| VA | SENTARA | O81064 | 01 |
| VA | VALU OPTIONS | 033408 | 01 |
| VA | ANTHEM | 453369 | 01 |
| Street Address |
289 INDEPENDENCE BLVD PEMBROKE 3 STE 221 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23462-5493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811998016 | Sreeja Kadakkal | Specialist | 289 Independence Blvd, Ste 312, Virginia Beach, VA 23462-5493 | 2005-08-10 |
| 1942651161 | Demaris Santiago | Social Worker | 289 Independence Blvd, Suite 245, Virginia Beach, VA 23462-5493 | 2016-06-29 |
| 1477926368 | Sarah Mitchell | Counselor | 289 Independence Blvd, Suite 245, Virginia Beach, VA 23462-5493 | 2015-11-02 |
| 1538535109 | Elizabeth A Custodero | Social Worker | 289 Independence Blvd, Suite 312, Virginia Beach, VA 23462-5493 | 2015-08-18 |
| 1912389909 | Kyle Keller | Counselor | 289 Independence Blvd, Ste 312, Virginia Beach, VA 23462-5493 | 2015-06-25 |
| 1447652375 | Denise Smith | Social Worker | 289 Independence Blvd, Suite 312, Virginia Beach, VA 23462-5493 | 2014-09-23 |
| 1487054961 | Tiana Minter | Social Worker | 289 Independence Blvd, Suite 245, Virginia Beach, VA 23462-5493 | 2014-09-03 |
| 1891105037 | Jessica Malone | Counselor | 289 Independence Blvd, Suite 312, Virginia Beach, VA 23462-5493 | 2014-04-28 |
| 1164842423 | Melissa Mary Caldwell | Social Worker | 289 Independence Blvd, Pembroke 3 Suite 221, Virginia Beach, VA 23462-5493 | 2014-04-24 |
| 1326464173 | Margaret Mary Morris | Counselor | 289 Independence Blvd, Suite 312, Virginia Beach, VA 23462-5493 | 2014-03-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912534082 | Cheyenne James | Counselor | 297 Independence Blvd., Virginia Beach, VA 23462 | 2020-03-26 |
| 1245871011 | Marathon Transportation Services LLC | Non-emergency Medical Transport (VAN) | 4505 Main Street, Apt 259, Virginia Beach, VA 23462 | 2019-10-03 |
| 1003475153 | Keyuri S Shah | Physical Therapist | 5701 Cleveland St, Ste 600, Virginia Beach, VA 23462 | 2019-06-12 |
| 1629561329 | Mary Katherine Pratt | Physician Assistant | 828 Healthy Way Ste 350, Virginia Beach, VA 23462 | 2018-06-07 |
| 1801387808 | Matrixx Healthcare LLC | Respite Care | 405 S Parliament Dr Ste 106, Virginia Beach, VA 23462 | 2018-05-24 |
| 1518471671 | Newtown Chiropractic Center Pllc | Clinic/Center | 5777 Princess Ann Road, Virginia Beach, VA 23462 | 2017-11-28 |
| 1528587995 | Gary Lee Alexander II | Counselor | 870 N Newtown Road, Virginia Beach, VA 23462 | 2017-09-16 |
| 1801328810 | Servitium Med Va, LLC | Durable Medical Equipment & Medical Supplies | 4445 Corporation Lane Suite 291, Virginia Beach, VA 23462 | 2017-03-29 |
| 1215476171 | Johnnie Walter Cox IIi | Emergency Medical Technician, Basic | 5163 Cleveland Street, Virginia Beach, VA 23462 | 2017-02-13 |
| 1225570179 | Holly Balsamo | Occupational Therapy Assistant | 5345 Marian Lane, Virginia Beach, VA 23462 | 2016-11-09 |
| Find all providers in zip 23462 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851864094 | Erica Genevieve Johns | Counselor | 253 C Street, Camp Pendleton, Virginia Beach, VA 23451 | 2019-01-10 |
| 1942725429 | Adebisi Olumuyiwa Osibogun | Counselor | 1109 Love Ct, Virginia Beach, VA 23464-5011 | 2017-08-07 |
| 1487198073 | Hopewell Counseling | Counselor | 4500 Holland Office Park, Suite 320, Virginia Beach, VA 23452-1146 | 2016-12-15 |
| 1235599713 | Manny Lee Garduque | Counselor | 5163 Cleveland St, Virginia Beach, VA 23462-6501 | 2016-02-26 |
| 1356770366 | Amanda Albright | Counselor | 5267 Greenwich Rd Ste 101e, Virginia Beach, VA 23462-6028 | 2013-11-11 |
| 1821435694 | Community Counseling Resources | Counselor | 780 Lynnhaven Pkwy Ste 380, Virginia Beach, VA 23452-7332 | 2013-06-03 |
| 1649511874 | Jerious Counseling Services, LLC | Counselor | 5108 Greenwich Road, Virginia Beach, VA 23462 | 2013-03-13 |
| 1043571276 | Wanda T Giles | Counselor | 1 Columbus Ctr Ste 665, Virginia Beach, VA 23462-6722 | 2012-06-05 |
| 1730322611 | Jonathan Eric Smith | Counselor | 1664 Chestwood Dr, Virginia Beach, VA 23453-7064 | 2009-04-08 |
| 1316168487 | Meredith Tebbe | Counselor | 1213 Laskin Rd Ste 106, Virginia Beach, VA 23451-5277 | 2007-05-02 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23462 |
Please comment or provide details below to improve the information on DR. ANTHONY H BRUDER.
| 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.