Active NPI
Kindal Holly Dahlby, LPC, MA
- Professional Counselor
- Forest, VA
National Provider Identifier
1730927344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701013780
- Practice address
- 316 Brook Park PL
Forest, VA 24551-2766 - Phone
- (434) 533-1088
- Fax
- (434) 616-2999
- NPI assigned
- Jul 17, 2024
- Last updated
- Jul 17, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 0701013780 | VA | Primary |
Addresses
Primary practice location
316 Brook Park PL
Forest, VA 24551-2766
Mailing address
11391 Anderson Hwy
Gladstone, VA 24553-3355
Phone (515) 419-8427
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701013780 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Impact Living Services | Professional | Current | Accepting new patients |
Locations
316 Brook Park Pl
Forest, VA 24551
Phone (434) 515-0877
316 Brook Park Pl
Ste A1
Forest, VA 24551
Phone (434) 533-1088
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Professional Counselor
- Forest, VA
- NPI 1487054342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721174400000",
"number": "1730927344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11391 ANDERSON HWY",
"city": "GLADSTONE",
"state": "VA",
"postal_code": "245533355",
"telephone_number": "515-419-8427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 BROOK PARK PL",
"city": "FOREST",
"state": "VA",
"postal_code": "245512766",
"telephone_number": "434-533-1088",
"fax_number": "434-616-2999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHLBY",
"first_name": "KINDAL",
"middle_name": "HOLLY",
"credential": "LPC, MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-17",
"last_updated": "2024-07-17",
"certification_date": "2024-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701013780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Forest, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.