WANDA A. CROCKETT (LPC) – Professional Counselor, NPI 1003803578

WANDA A. CROCKETT (LPC) is a healthcare provider. based in Richmond, Virginia. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. 07010000950 (VA). The NPI Number for WANDA A. CROCKETT (LPC) is 1003803578

Main info

Female
52 Years Of Experience
Accepts Medicare Assignment
Name
WANDA A. CROCKETT (LPC)
NPI
1003803578
Phone
(804) 288-1881
Address
2006 BREMO RD
Enumeration Date
30 September 2005
Last Update Date
18 November 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8042884881
Graduation Year
1974 (52 years ago)
PAC ID
9537534672
Group Practice PAC ID
2860394178
Professional Enrollment ID
I20240416002302
Address ID
VA232944422RI2810XRDXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,998 MENTAL HEALTH COUNSELOR in VA

Provider Addresses for WANDA A. CROCKETT (LPC)

  • 2006 BREMO RD

    SUITE 101

    RICHMOND, VA 232262438

    Phone: (804) 288-1881

    Fax: (804) 288-1881

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-04-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240416002302IMental Health CounselorVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 23226)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860394178View full group profile
NameSpecialtyState
Nurse PractitionerMD
P S Y C H I A T R YVA
Nurse PractitionerUT
Clinical Social WorkerVA
P S Y C H I A T R YVA
Nurse PractitionerVA
Psychiatry, NeurologyVA
Physician AssistantVA
Nurse PractitionerVA
-VA

Reviews

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Frequently asked questions

Where can patients find WANDA A. CROCKETT (LPC)'s NPI?
You can confirm WANDA A. CROCKETT (LPC) with NPI 1003803578; it appears in the national provider directory.
Is WANDA A. CROCKETT (LPC)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does WANDA A. CROCKETT (LPC) work in?
You can think of WANDA A. CROCKETT (LPC) as practicing within Professional Counselor. Clinical services aligned with this taxonomy classification.
Where is WANDA A. CROCKETT (LPC)'s primary listing?
We display Richmond, Virginia because that is what the record indicates for WANDA A. CROCKETT (LPC).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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