Rewired Canvas Psychotherapy LLC
NPI 1457171563ActiveOrganization· Counselor, Professional· Norfolk, VA
Counselor, Professional in Norfolk, Virginia, registered in NPPES in October 2024. The authorized official on file is Kerry Ann Kruk-Borisov, LPC, ATR-BC, CSAC, Owner / Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1457171563 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 14, 2024 |
| Last updated in NPPES | Mar 27, 2025 |
| Certified by provider | Mar 27, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | — | — |
| Art Therapist | 221700000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (VA) |
|---|
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