Individual provider Active NPI

Laura Kangelaris

  • Marriage & Family Therapist
  • Glen Allen, VA
National Provider Identifier
1891446084
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0730000438 Issued in VA
Practice address
11357 Nuckols Rd # 1186
Glen Allen, VA 23059-5504
Phone
(804) 655-0677
NPI assigned
Jan 10, 2022
Last updated
Sep 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0730000438 VA Primary
Marriage & Family Therapist 106H00000X LCM18519 MD

Addresses

Primary practice location

11357 Nuckols Rd # 1186
Glen Allen, VA 23059-5504

Mailing address

11357 Nuckols Rd # 1186
Glen Allen, VA 23059-5504
Phone (804) 655-0677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 28, 2024 through Feb 29, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0730000438VAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Connection, Healing & Change Marriage & Family Therapist PastSince Jan 21, 2022 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1891446084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11357 NUCKOLS RD # 1186",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595504",
            "telephone_number": "804-655-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11357 NUCKOLS RD # 1186",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595504",
            "telephone_number": "804-655-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANGELARIS",
        "first_name": "LAURA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0730000438",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MD",
            "license": "LCM18519",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

Verify at the official NPI Registry.