Individual provider Active NPI

Carolyn Elizabeth Kuchel, LPC, CSAC

  • Professional Counselor
  • Fairfax, VA
National Provider Identifier
1861724445
Registry record updated Feb 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701004756 Issued in VA
Practice address
4505 Shirley Gate Rd
Fairfax, VA 22030-5522
Phone
(703) 352-2205
NPI assigned
Feb 5, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0701004756 VA
Professional Counselor 101YP2500X 0701004756 VA Primary
Marriage & Family Therapist 106H00000X 0701004756 VA

Addresses

Primary practice location

4505 Shirley Gate Rd
Fairfax, VA 22030-5522

Mailing address

4505 Shirley Gate Rd
Fairfax, VA 22030-5522
Phone (703) 352-2205

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
0701004756VAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265328000000",
    "number": "1861724445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 SHIRLEY GATE RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305522",
            "telephone_number": "703-352-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 SHIRLEY GATE RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305522",
            "telephone_number": "703-352-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCHEL",
        "first_name": "CAROLYN",
        "middle_name": "ELIZABETH",
        "credential": "LPC, CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-05",
        "last_updated": "2010-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0701004756",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004756",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0701004756",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; 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.