Active NPI
Ian Demodna, M.A. COUNSELING
- Professional Counselor
- Williamsburg, VA
National Provider Identifier
1669919833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 1001 Richmond Rd
Williamsburg, VA 23185-2895 - Phone
- (757) 784-8790
- Fax
- (757) 208-0829
- NPI assigned
- Jan 26, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary | ||
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
1001 Richmond Rd
Williamsburg, VA 23185-2895
Mailing address
1001 Richmond Rd
Williamsburg, VA 23185-2895
Phone (757) 784-8790
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485388800000",
"number": "1669919833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 RICHMOND RD",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231852895",
"telephone_number": "757-784-8790",
"fax_number": "757-208-0829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 RICHMOND RD",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231852895",
"telephone_number": "757-784-8790",
"fax_number": "757-208-0829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMODNA",
"first_name": "IAN",
"credential": "M.A. COUNSELING",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-26",
"last_updated": "2017-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamsburg, VA
- Deel Transportation LLC
- Bruce R Deginder, D.D,S,
- Carmela Evangelista Del Espiritu Santo, PT, DPT, CLT
- Rachel Gross Delbos
- Kenya Delvalle, DHSC, MS, BS
- Gwinn Dennis, MSW
- Dental Professionals of Virginia, P.C
- Dental Professionals of Virginia, P.C.
- Dental Professionals of Virginia, P.C.
- Dental Professionals of Virginia, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.