REWIRED CANVAS PSYCHOTHERAPY LLC
NPI 1457171563
Counselor - Professional in Norfolk, VA
About Rewired Canvas Psychotherapy Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REWIRED CANVAS PSYCHOTHERAPY LLC (NPI 1457171563) is a healthcare organization registered as a professional in Norfolk, Virginia and active in the NPI registry since October 2024. The organization lists Kerry Ann Kruk-borisov, Owner / Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Rewired Canvas Psychotherapy Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Rewired Canvas Psychotherapy LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Rewired Canvas Psychotherapy LLC's NPI number?
The NPI number for Rewired Canvas Psychotherapy LLC is 1457171563. It was assigned to this organization in the NPPES registry on October 14, 2024.
Where is Rewired Canvas Psychotherapy LLC located?
Rewired Canvas Psychotherapy LLC is located at 2200 Colonial Ave Ste 12, Norfolk, VA 23517. The listed phone number is (757) 589-3498.
What is Rewired Canvas Psychotherapy LLC's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Rewired Canvas Psychotherapy LLC enrolled in Medicare?
Yes. Rewired Canvas Psychotherapy LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Rewired Canvas Psychotherapy LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Mental Health Counselor) reassigns their Medicare billing to Rewired Canvas Psychotherapy LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Rewired Canvas Psychotherapy LLC was last updated on March 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Rewired Canvas Psychotherapy Llc · NPI 1457171563
Professional organization in Norfolk, Virginia. Organization record, active in the CMS NPPES registry since October 14, 2024.
## Identity
- **NPI:** 1457171563 (Entity type: Organization)
- **Enumerated:** October 14, 2024
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **Organization subpart:** No
- **Authorized official:** Kerry Kruk-Borisov, OWNER / MANAGER
## Practice location
- **Address:** 2200 COLONIAL AVE STE 12, Norfolk, VA 23517-1919
- **Phone:** (757) 589-3498
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Mental Health Counselor) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 27, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1457171563) · Data from the CMS NPPES public registry.