Kingfisher Psychotherapy, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

KINGFISHER PSYCHOTHERAPY, LLC

Practice address

1628 Meadowbrook Heights Rd
Charlottesville, VA 22901-3001

Phone

(859) 559-3722

NPI assigned

Sep 13, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Ethan Kyle Richardson, LCSWNPI 1366035727

Title

Owner

Phone

(859) 559-3722

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ethan Kyle Richardson, MSW

  • Clinical Social Worker
  • Charlottesville, VA
  • NPI 1366035727
  NPD Authorized official

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1316773476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 MEADOWBROOK HEIGHTS RD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229013001",
            "telephone_number": "859-559-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 MEADOWBROOK HEIGHTS RD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229013001",
            "telephone_number": "859-559-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGFISHER PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-13",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-559-3722",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L King, MD
• Kaamilya King, RN, MSN, WHNP-BC
• Movicque F King, MD
• Roy Daimont King
• Megan E. Kingdon, NP
• Rebecca A Kinsley, AG-ACNP
• Julianna Kinsolving, MD
• Amy S. Kipp, M.D.
• Jennifer L. Kirby, M.D.
• John C. Kirchgessner, N.P.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.