Individual provider Active NPI

Cheryl Edwards Ponton, LPC-R

  • Addiction (Substance Use Disorder) Counselor
  • South Prince George, VA
National Provider Identifier
1699385385
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
0704011400 Issued in VA
Practice address
10543 S Crater Rd
South Prince George, VA 23805-7333
Phone
(804) 431-5585
NPI assigned
Aug 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0704011400 VA Primary

Addresses

Primary practice location

10543 S Crater Rd
South Prince George, VA 23805-7333

Mailing address

10543 S Crater Rd
South Prince George, VA 23805-7333
Phone (804) 431-5585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231228003179 VA Practitioner - Mental Health Counselor 6002266392 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0704011400VAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Pac Services PC CurrentSince Nov 4, 2024 Accepting new patients
Aevum BH VA LLC CurrentSince Jan 13, 2025 Accepting new patients
CS Pacs 3 Southeast, LLC CurrentSince Nov 4, 2024 Accepting new patients
NV Pacs 2 LLC CurrentSince Nov 4, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients
Aevum Behavioral Health VA LLC PastSince Sep 1, 2024 Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

15051 Harmony Hills Ln
Abingdon, VA 24211
Phone (276) 451-2590

1 Vantage Dr
Poquoson, VA 23662
Phone (757) 868-9660

4403 Forest Hill Ave
Richmond, VA 23225
Phone (804) 231-0231

Organizations & group practices 6

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": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1699385385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10543 S CRATER RD",
            "city": "SOUTH PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238057333",
            "telephone_number": "804-431-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10543 S CRATER RD",
            "city": "SOUTH PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238057333",
            "telephone_number": "804-431-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTON",
        "first_name": "CHERYL",
        "middle_name": "EDWARDS",
        "credential": "LPC-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0704011400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Prince George, VA

Sources for this page

Verify at the official NPI Registry.