Katelyn Elizabeth Childs
Individual provider Active NPI Professional Counselor · Forest, VA
NPI 1427636679 · NPPES record last updated Apr 2, 2021
Key facts
- NPI
- 1427636679
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 0701010378 (VA)
- Practice address
- 110 Vista Centre Dr Ste 18
Forest, VA 24551-2775 - Phone
- (434) 316-6025
- Fax
- (434) 316-7025
- NPI assigned
- Mar 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701010378 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Counseling & Consulting for Meaningful Change, LLC | Professional | Current |
Accepting new patients |
Locations
110 Vista Centre Dr
Ste 18
Forest, VA 24551
Phone (434) 207-2497
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701010378 | VA | Yes |
Addresses
Primary practice location
110 Vista Centre Dr Ste 18
Forest, VA 24551-2775
Mailing address
1107 Cottontown Manor Dr Apt 302
Forest, VA 24551-2539
Phone (434) 238-7709
Other providers in Forest, VA
- Central Virginia Family Physicians, Inc
- Central Virginia Family Physicians, Inc
- Central Virginia Medical Transportation
- John Chappell V
- Jordyn Chaverri
- Chiropractic Care Center
- Christian Counseling Services
- Secelia Clark
- April Clarke
- Evelyn Clinton
All providers in Forest, 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 Apr 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.