Individual provider Active NPI

Kurt Michael Stiefvater, LPC

  • Professional Counselor
  • Glen Allen, VA
National Provider Identifier
1114052347
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701001675 Issued in VA
Practice address
10299 Woodman Rd
Glen Allen, VA 23060-4419
Phone
(804) 727-8500
Fax
(804) 727-8580
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0701001675 VA Primary

Addresses

Primary practice location

10299 Woodman Rd
Glen Allen, VA 23060-4419

Mailing address

10299 Woodman Rd
Glen Allen, VA 23060-4419
Phone (804) 727-8500

Other identifiers 3

IdentifierTypeStateIssuer
4945131OtherVAVIRGINIA PREMIER
085726OtherVASENTARA
110324OtherVAANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701001675VAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114052347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10299 WOODMAN RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230604419",
            "telephone_number": "804-727-8500",
            "fax_number": "804-727-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10299 WOODMAN RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230604419",
            "telephone_number": "804-727-8500",
            "fax_number": "804-727-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIEFVATER",
        "first_name": "KURT",
        "middle_name": "MICHAEL",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701001675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER",
            "identifier": "4945131",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "085726",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "110324",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

Verify at the official NPI Registry.