Active NPI
Kayla Madison Rae Edwards
- Professional Counselor
- Chesapeake, VA
National Provider Identifier
1093536781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 07-04017484
- Practice address
- 501 Cedar Rd Ste 2a
Chesapeake, VA 23322-5527 - Phone
- (757) 302-8362
- NPI assigned
- Oct 24, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 07-04017484 | VA | Primary |
Addresses
Primary practice location
501 Cedar Rd Ste 2a
Chesapeake, VA 23322-5527
Mailing address
705 Inlet Quay Apt C
Chesapeake, VA 23320-9295
Phone (757) 633-4195
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07-04017484 | VA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729728000000",
"number": "1093536781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 INLET QUAY APT C",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233209295",
"telephone_number": "757-633-4195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 CEDAR RD STE 2A",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233225527",
"telephone_number": "757-302-8362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "KAYLA",
"middle_name": "MADISON RAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-24",
"last_updated": "2024-10-24",
"certification_date": "2024-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "07-04017484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.