Individual provider Active NPI

Kimberly Wormuth, LPC

  • Professional Counselor
  • Danville, VA
National Provider Identifier
1417917758
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701003094 Issued in VA
Practice address
245 Hairston St
Danville, VA 24540-4137
Phone
(434) 793-4931
Fax
(434) 799-3100
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701003094 VA Primary

Addresses

Primary practice location

245 Hairston St
Danville, VA 24540-4137

Mailing address

245 Hairston St
Danville, VA 24540-4137
Phone (434) 793-4931

Other identifiers 1

IdentifierTypeStateIssuer
004945085MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701003094VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family of Hands, LLC Professional CurrentSince May 14, 2024 Accepting new patients

Locations

500 Piney Forest Rd
Danville, VA 24540
Phone (434) 272-8372

105 Vicar Pl
Danville, VA 24540
Phone (434) 272-8372

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1417917758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 HAIRSTON ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245404137",
            "telephone_number": "434-793-4931",
            "fax_number": "434-799-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 HAIRSTON ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245404137",
            "telephone_number": "434-793-4931",
            "fax_number": "434-799-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORMUTH",
        "first_name": "KIMBERLY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945085",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.