Kenneth Adrian Deneault, LPC
Individual provider Active NPI Professional Counselor · Dillwyn, VA
NPI 1235600784 · NPPES record last updated Dec 10, 2018
Key facts
- NPI
- 1235600784
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 0701007852 (VA)
- Practice address
- 17039 Oak St
Dillwyn, VA 23936-3019 - Phone
- (434) 808-0604
- Fax
- (434) 808-0716
- NPI assigned
- Dec 10, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Virginia Center for Family Relations, PC
Practice addresses (Care Compare)
1450 Sachem PL
Suite 101
Charlottesville, VA 22901-2554
Phone (434) 973-5640
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250114001899 | VA | Practitioner - Mental Health Counselor | 2769910009 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia Center for Family Relations, PC | Current |
Accepting new patients | |
| South Central Counseling Group | Past | Accepting new patients |
Locations
1450 Sachem Pl
Unit 101
Charlottesville, VA 22901
Phone (434) 973-5640
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701007852 | VA | Yes |
Addresses
Primary practice location
17039 Oak St
Dillwyn, VA 23936-3019
Mailing address
PO Box 1166
Dillwyn, VA 23936-1166
Other providers in Dillwyn, VA
- Charlottesville League of Therapists, Inc
- Jinwoo Choi
- Michelle Randall Cox
- Cradle to Table Pediatric Therapy, LLC
- Sophia A Dannouf
- Amanda Rose Dillabough
- Dillwyn Life Care, LLC
- Dillwyn Life Care, LLC
- Donald Lee Driscoll
- Bailey Katherine Grant-Dickerson
All providers in Dillwyn, VA · Professional Counselor in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.