Kaylyn Riley Proctor, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904017246 Issued in VA

Practice address

610 Campus Dr
Abingdon, VA 24210-2589

Phone

(276) 525-1550

Fax

(276) 525-1609

NPI assigned

Aug 19, 2024

Last updated

Dec 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Highlands Community Services

  • Community/Behavioral Health Agency
  • Abingdon, VA
  • NPI 1396774147

  Single Specialty

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1053143933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 CAMPUS DR",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242102589",
            "telephone_number": "276-525-1550",
            "fax_number": "276-525-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 CAMPUS DR",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242102589",
            "telephone_number": "276-525-1550",
            "fax_number": "276-525-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "KAYLYN",
        "middle_name": "RILEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904017246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Preston Square Family Practice
• William Fred Prestowitz, MD
• April D Price, LPN
• Madelyn Hyde Price, DO
• Laura Ellen Pritchard-Compton, MSW, MED
• Ashley Renae Pruitt, COTA/L
• Psych Services PC (Elvera E. McLees, Ph.D.)
• Gloria Jean Puckett, COTA/L
• Terry Lee Puckett, M.D., M.P.H.
• Laith Osama Ahmad Qasarweh, M.D.

• Clinical Social Worker in Abingdon, VA
• Providers in Abingdon, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.