Individual provider Active NPI

Keshia Diane Ingram, MA,LPC

  • Professional Counselor
  • Newport News, VA
National Provider Identifier
1043824675
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701009950 Issued in VA
Practice address
714 J Clyde Morris Blvd Ste 180
Newport News, VA 23601-1535
Phone
(757) 706-3309
NPI assigned
Sep 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701009950 VA Primary

Addresses

Primary practice location

714 J Clyde Morris Blvd Ste 180
Newport News, VA 23601-1535

Mailing address

4A Dorsey Rd
Apt a
Newport News, VA 23606
Phone (757) 239-1786

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
I20240903001896 VA Practitioner - Mental Health Counselor 0345789467 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifebulb LLCGroup PAC ID 2062881162, 97 clinicians

Practice addresses (Care Compare)

2340 Commonwealth Dr
Suite 101
Charlottesville, VA 22901-1634
Phone (434) 214-6556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0701009950VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebulb LLC Mental Health CurrentSince Jun 1, 2024 Accepting new patients
Rhodium Care Group Inc CurrentSince Mar 16, 2025 Accepting new patients
Central Virginias Preferred Providers Mental Health CurrentSince Jul 18, 2024 Accepting new patients
Thrive Counseling LLC Mental Health PastSince Sep 1, 2021 Accepting new patients

Locations

505 Main St
Toms River, NJ 08753
Phone (732) 272-0127

6210 Old Franconia Rd
#A
Alexandria, VA 22310
Phone (703) 955-3703

8830 Virginia St
Amelia Ct Hse, VA 23002
Phone (804) 561-5611

2340 Commonwealth Dr
Ste 101
Charlottesville, VA 22901
Phone (732) 451-3895

2421 Westwood Ave
Ste F
Richmond, VA 23230
Phone (804) 317-2288

5911 W Broad St
Richmond, VA 23230
Phone (804) 213-0259

Organizations & group practices 4

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": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1043824675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4A DORSEY RD",
            "address_2": "APT A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23606",
            "telephone_number": "757-239-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 J CLYDE MORRIS BLVD STE 180",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011535",
            "telephone_number": "757-706-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "KESHIA",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "MA,LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701009950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.