Active NPI
Kerry Maldiner, LMFT
- Marriage & Family Therapist
- Chesapeake, VA
National Provider Identifier
1194100198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 0717001333
- Practice address
- 103 Watson Rd
Chesapeake, VA 23320-5527 - Phone
- (619) 357-8752
- NPI assigned
- Jul 21, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 0717001333 | VA | Primary |
Addresses
Primary practice location
103 Watson Rd
Chesapeake, VA 23320-5527
Mailing address
103 Watson Rd
Chesapeake, VA 23320-5527
Phone (619) 357-8752
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 |
|---|---|---|---|
| 0717001333 | VA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1194100198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 WATSON RD",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233205527",
"telephone_number": "619-357-8752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 WATSON RD",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233205527",
"telephone_number": "619-357-8752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDINER",
"first_name": "KERRY",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-21",
"last_updated": "2024-10-31",
"certification_date": "2024-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "VA",
"license": "0717001333",
"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 31, 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.