Individual provider Active NPI

Karla Sue Coughenour, RDN, LCMHC, LPC

  • Professional Counselor
  • Suffolk, VA
National Provider Identifier
1174776041
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
A13025 Issued in NC
Practice address
7007 Porthole PL
Suffolk, VA 23435-3543
Phone
(757) 814-3436
NPI assigned
Oct 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NC
Professional Counselor 101YP2500X A13025 NC Primary

Addresses

Primary practice location

7007 Porthole PL
Suffolk, VA 23435-3543

Mailing address

7007 Porthole PL
Suffolk, VA 23435-3543
Phone (252) 305-3369

Other names 1

  • Karla Croyle Other name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
A13025NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbank Wellness, LLC Professional Current Accepting new patients
Thrivewell Network LLC Professional PastSince Aug 1, 2019 Accepting new patients
The Outer Banks Hospital Inc Past Accepting new patients

Locations

214 College Park Plz
Ste 215
Johnstown, PA 15904
Phone (757) 814-3436

Organizations & group practices 3

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": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1174776041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7007 PORTHOLE PL",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353543",
            "telephone_number": "252-305-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7007 PORTHOLE PL",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353543",
            "telephone_number": "757-814-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGHENOUR",
        "first_name": "KARLA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "RDN, LCMHC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-23",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A13025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARLA",
            "last_name": "CROYLE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.

Verify at the official NPI Registry.