Active NPI
Kathryn Gwaltney Nicholas, LPC
- Professional Counselor
- Suffolk, VA
National Provider Identifier
1548613912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701006687
- Practice address
- 129 N Saratoga St
Suite 1
Suffolk, VA 23434-5255 - Phone
- (757) 539-5353
- Fax
- (757) 539-5399
- NPI assigned
- Jul 20, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701006687 | VA | Primary |
Addresses
Primary practice location
129 N Saratoga St
Suite 1
Suffolk, VA 23434-5255
Mailing address
129 N Saratoga St
Suite 1
Suffolk, VA 23434-5255
Phone (757) 539-5353
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701006687 | VA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481155200000",
"number": "1548613912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 N SARATOGA ST",
"address_2": "SUITE 1",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234345255",
"telephone_number": "757-539-5353",
"fax_number": "757-539-5399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 N SARATOGA ST",
"address_2": "SUITE 1",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234345255",
"telephone_number": "757-539-5353",
"fax_number": "757-539-5399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLAS",
"first_name": "KATHRYN",
"middle_name": "GWALTNEY",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-20",
"last_updated": "2016-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701006687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suffolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.