KMDT Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0904007119 Issued in VA

Legal business name

KMDT SERVICES LLC

Doing business as

Signs of Change Counseling

Practice address

8420 Dorsey Cir
Manassas, VA 20110-8300

Phone

(571) 279-8144

NPI assigned

Nov 12, 2015

Organization subpart

No

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

Authorized official

Name

Katharine Helene McHugh, LCSW

Title

President

Phone

(571) 279-8144

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Signs of Change Counseling Doing business as

Locations

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

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1801269857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7937 FLAGER CIR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201097437",
            "telephone_number": "571-279-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8420 DORSEY CIR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201108300",
            "telephone_number": "571-279-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KMDT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-12",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "MCHUGH",
        "authorized_official_first_name": "KATHARINE",
        "authorized_official_middle_name": "HELENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "571-279-8144",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "0904007119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945247",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "020063P10",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signs of Change Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kkache Enterprises, Inc
• Susan Kay Kloha, BCBA
• Rebecca C Knerr, PA
• Bradford Knight, MD
• Carrie Trogdon Knox, LPC
• Roberta Hope Knussman, LCSW
• Andrew Koch, CRNA

• Community/Behavioral Health Agency in Manassas, VA
• Providers in Manassas, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.