Individual provider Active NPI

Kelley M Cahoon, LPC, NCC

  • Counselor
  • Fairfax, VA
National Provider Identifier
1316074784
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
0701003458 Issued in VA
Practice address
10372 Democracy LN
Fairfax, VA 22030-2522
Phone
(703) 591-2551
Fax
(703) 591-2563
NPI assigned
Feb 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 0701003458 VA Primary

Addresses

Primary practice location

10372 Democracy LN
Fairfax, VA 22030-2522

Mailing address

10372 Democracy LN
Fairfax, VA 22030-2522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: No
  • 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
I20240325001478 VA Practitioner - Mental Health Counselor 2365889490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701003458VAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Practical Therapeutic Solutions, PLLC Past Accepting new patients

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316074784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10372 DEMOCRACY LN",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10372 DEMOCRACY LN",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302522",
            "telephone_number": "703-591-2551",
            "fax_number": "703-591-2563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAHOON",
        "first_name": "KELLEY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": "0701003458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.