Individual provider Active NPI

Davida Faltz

  • Mental Health Counselor
  • Virginia Beach, VA
National Provider Identifier
1790356418
Registry record updated Jul 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3403 Issued in VA
Practice address
900 Commonwealth PL
Virginia Beach, VA 23464-4517
Phone
(757) 597-1909
NPI assigned
Jul 3, 2021
Last updated
Jul 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0732001362 VA
Mental Health Counselor 101YM0800X 3403 VA Primary

Addresses

Primary practice location

900 Commonwealth PL
Virginia Beach, VA 23464-4517

Mailing address

900 Commonwealth PL
Virginia Beach, VA 23464-4517
Phone (757) 597-1909

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

LicenseStateTypeSpecialty
0732001362VAMDMental Health Counselor
3403VAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Restored Minds Counseling Group Inc. Mental Health Current Accepting new patients
Destined for Brighter Futures Foundation LLC Mental Health Current Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625270400000",
    "number": "1790356418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 COMMONWEALTH PL",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644517",
            "telephone_number": "757-597-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 COMMONWEALTH PL",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644517",
            "telephone_number": "757-597-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALTZ",
        "first_name": "DAVIDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-03",
        "last_updated": "2021-07-03",
        "certification_date": "2021-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0732001362",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "3403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.