NPIMap

Organization Active NPI

Buckhorn Lane Counseling, PLLC

  • Clinical Social Worker
  • Fredericksburg, VA
National Provider Identifier
1235433699
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904006912 Issued in VA
Legal business name
BUCKHORN LANE COUNSELING, PLLC
Practice address
2217 Princess Anne St
Suite 105-5
Fredericksburg, VA 22401-3382
Phone
(540) 371-1006
Fax
(540) 371-1911
NPI assigned
Dec 28, 2010
Last updated
Jan 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Authorized official

Name
Mrs. Rachel H Edmunds, LCSWNPI 1093951501
Title
Owner, Sole Provider
Phone
(540) 371-1006

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904006912 VA Primary

Addresses

Primary practice location

2217 Princess Anne St
Suite 105-5
Fredericksburg, VA 22401-3382

Mailing address

2217 Princess Anne St
Suite 105-5
Fredericksburg, VA 22401-3382
Phone (540) 371-1006

Other identifiers 3

IdentifierTypeStateIssuer
0904006912OtherVAVA LCSW LICENSE
11902767OtherCAQH
1093951501MedicaidVA

National Provider Directory

National Provider Directory

Locations

2217 Princess Anne St
Ste 105-5
Fredericksburg, VA 22401
Phone (540) 371-1006

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294012800000",
    "number": "1235433699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 PRINCESS ANNE ST",
            "address_2": "SUITE 105-5",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013382",
            "telephone_number": "540-371-1006",
            "fax_number": "540-371-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 PRINCESS ANNE ST",
            "address_2": "SUITE 105-5",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013382",
            "telephone_number": "540-371-1006",
            "fax_number": "540-371-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKHORN LANE COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-28",
        "last_updated": "2011-01-03",
        "status": "A",
        "authorized_official_last_name": "EDMUNDS",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER, SOLE PROVIDER",
        "authorized_official_telephone_number": "540-371-1006",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA LCSW LICENSE",
            "identifier": "0904006912",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11902767",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093951501",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; 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.