Individual provider Active NPI

Linda D Kelly, LPC

  • Professional Counselor
  • Gloucester, VA
National Provider Identifier
1043339864
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701014545 Issued in VA
Practice address
9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162
Phone
(804) 695-8120
Fax
(804) 695-8122
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 171M00000X VA
Professional Counselor 101YP2500X 0701014545 VA Primary

Addresses

Primary practice location

9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162

Mailing address

379 Wilson LN
Weems, VA 22576-2202

Other practice location 1

5372 B Old Virginia Street
Urbanna, VA 23175
Phone (804) 758-5250 ext. 114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250417000555 VA Practitioner - Mental Health Counselor 1951826460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

330 Hospital Rd
Tappahannock, VA 22560-5070
Phone (804) 695-8120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
171M00000XVAMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Peninsula Northern Neck Mental Health & Retardation CurrentSince Feb 14, 2025 Accepting new patients
Middle Peninsula-Northern Neck Mental Health and Mental Retardation CurrentSince Feb 14, 2025 Accepting new patients

Locations

9228 George Washington Memorial Hwy
Gloucester, VA 23061
Phone (804) 693-5057

1041 Sharon Rd
Ste 201
King William, VA 23086
Phone (804) 769-2751

330 Hospital Rd
Tappahannock, VA 22560
Phone (804) 695-8120

5372B Old Virginia St
Urbanna, VA 23175
Phone (804) 758-5250

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1043339864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 WILSON LN",
            "city": "WEEMS",
            "state": "VA",
            "postal_code": "225762202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614162",
            "telephone_number": "804-695-8120",
            "fax_number": "804-695-8122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5372 B Old Virginia Street",
            "address_purpose": "LOCATION",
            "city": "Urbanna",
            "state": "VA",
            "postal_code": "23175",
            "country_code": "US",
            "telephone_number": "804-758-5250 x114",
            "fax_number": "804-758-5183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LINDA",
        "middle_name": "D",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "VA",
            "license": "171M00000X",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701014545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, VA

Sources for this page

Verify at the official NPI Registry.