1. Home
  2. Directory
  3. Virginia
  4. Chesapeake
  5. Counselor
  6. NPI Profile

RESTORER OF BROKEN WALLS PC
NPI 1811080047
Counselor in Chesapeake, VA

Active since October 02, 2006
644 INDEPENDENCE PARKWAY, SUITE 200, CHESAPEAKE, VA 23320(757) 547-1811(757) 547-1118 Get Directions Write a Review

NPPES record last updated: August 20, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 20, 2024, Aug 22, 2020 (2 updates tracked since 2020).

About Restorer Of Broken Walls Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RESTORER OF BROKEN WALLS PC (NPI 1811080047) is a healthcare organization registered as a counselor in Chesapeake, Virginia and active in the NPI registry since October 2006. The organization lists Amanda Bowers Grizzard, Program Director, as its authorized official.

NPPES Registry Identity

NPI1811080047
Entity TypeOrganization
Primary Taxonomy101Y00000X
Legal Business NameRESTORER OF BROKEN WALLS PC
Location Address644 INDEPENDENCE PARKWAY, SUITE 200Chesapeake, VA 23320
Mailing Address644 Independence Parkway, Suite 200Chesapeake, VA 23320 · (757) 547-1811 · Fax (757) 547-1118
Phone(757) 547-1811
Fax(757) 547-1118
Organization SubpartNo
Authorized OfficialAmanda Bowers GrizzardProgram Director · (757) 547-1811
Enumeration DateOctober 2, 2006
Last NPPES UpdateAugust 20, 20242 updates tracked since enumeration
NPPES CertifiedJuly 31, 2024
✔ NPI 1811080047 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
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.
644 INDEPENDENCE PARKWAY, Chesapeake, VA 23320
Open in Google Maps ↗

Other Identifiers 1

Medicaid004944402VA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Restorer Of Broken Walls Pc 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 Restorer Of Broken Walls PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Lisa Willard, LPC
Mental Health Counselor
NPI 1386717171
930 REDGATE AVE
Norfolk, VA 23507
(757) 626-3733
✔ PECOS✔ Accepts Medicare7.2 mi

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 Restorer Of Broken Walls PC's NPI number?

The NPI number for Restorer Of Broken Walls PC is 1811080047. It was assigned to this organization in the NPPES registry on October 2, 2006.

Where is Restorer Of Broken Walls PC located?

Restorer Of Broken Walls PC is located at 644 Independence Parkway Suite 200, Chesapeake, VA 23320. The listed phone number is (757) 547-1811.

What is Restorer Of Broken Walls PC's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Restorer Of Broken Walls PC enrolled in Medicare?

Yes. Restorer Of Broken Walls PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Restorer Of Broken Walls PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Mental Health Counselor) reassigns their Medicare billing to Restorer Of Broken Walls PC. 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 Restorer Of Broken Walls PC was last updated on August 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.