Individual provider Active NPI

Karli Minnick

  • Professional Counselor
  • Yorktown, VA
National Provider Identifier
1114607421
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701015354 Issued in VA
Practice address
3630 George Washington Mem Hwy Ste F1
Yorktown, VA 23693-3350
Phone
(757) 204-1866
Fax
(757) 782-4004
NPI assigned
Jul 20, 2023
Last updated
Sep 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 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 0701015354 VA Primary

Addresses

Primary practice location

3630 George Washington Mem Hwy Ste F1
Yorktown, VA 23693-3350

Mailing address

3630 George Washington Mem Hwy Ste F1
Yorktown, VA 23693-3350
Phone (757) 204-1866

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
I20251015002231 VA Practitioner - Mental Health Counselor 3870080682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3630 George Washington Mem Hwy F1
Yorktown, VA 23693-3350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701015354VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jill M Nardin, LPC, PC Professional CurrentSince Jul 18, 2025 Accepting new patients

Locations

3630 George Washington Mem Hwy
Ste F1
Yorktown, VA 23693
Phone (757) 204-1866

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1114607421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 GEORGE WASHINGTON MEM HWY STE F1",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236933350",
            "telephone_number": "757-204-1866",
            "fax_number": "757-782-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 GEORGE WASHINGTON MEM HWY STE F1",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236933350",
            "telephone_number": "757-204-1866",
            "fax_number": "757-782-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNICK",
        "first_name": "KARLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-20",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701015354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorktown, VA

Sources for this page

Verify at the official NPI Registry.