Individual provider Active NPI

Jane M Kudlas, PH.D.

  • Clinical Psychologist
  • Richmond, VA
National Provider Identifier
1942381264
Registry record updated Nov 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Practice address
1250 E Marshall Street
Psychiatry
Richmond, VA 23298-0510
Phone
(804) 828-8707
Fax
(804) 827-4998
NPI assigned
Oct 17, 2006
Last updated
Nov 20, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X VA Primary

Addresses

Primary practice location

1250 E Marshall Street
Psychiatry
Richmond, VA 23298-0510

Mailing address

PO Box 91734
Richmond, VA 23291-1734
Phone (804) 358-6100

Other identifiers 1

IdentifierTypeStateIssuer
1942381264MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070917000500 VA Practitioner - Clinical Psychologist 4880788249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Commonwealth Counseling Associates IncGroup PAC ID 0941288583, 207 clinicians

Practice addresses (Care Compare)

15521 Midlothian Tpke
Suite 105
Midlothian, VA 23113-7313
Phone (804) 207-6737

9202 Ctr Oak CT
Mechanicsville, VA 23116-2744
Phone (804) 207-6737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
081002439VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Counseling Associates Inc Clinical CurrentSince Jul 1, 2007 Accepting new patients
MCV Associated Physicians PastSince Sep 28, 2021 Accepting new patients

Locations

9202 Center Oak Ct
Mechanicsvlle, VA 23116
Phone (804) 639-1112

15521 Midlothian Tpke
Ste 105
Midlothian, VA 23113
Phone (804) 423-1550

Interoperability endpoints

  • Direct secure messaging: commonwealthcounselingassociates.janekudlas@134000.advancedmd-direct.com

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195516800000",
    "number": "1942381264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91734",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232911734",
            "telephone_number": "804-358-6100",
            "fax_number": "804-342-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL STREET",
            "address_2": "PSYCHIATRY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980510",
            "telephone_number": "804-828-8707",
            "fax_number": "804-827-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDLAS",
        "first_name": "JANE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942381264",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.