Edward Gaham Canada III, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701007956 Issued in VA

Practice address

4191 Innslake Dr Ste 211
Glen Allen, VA 23060-3324

Phone

(804) 303-9622

NPI assigned

Oct 17, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Zoe Therapy Services, LLCGroup PAC ID 2769603901, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Zoe Therapy Services, LLC

  • Multi-Specialty Clinic/Center
  • Glen Allen, VA
  • NPI 1215352521
  Medicare reassignment Care Compare group NPD
• Zoestyle Medicine

  • Obesity Medicine (Preventive Medicine) Physician
  • Glen Allen, VA
  • NPI 1518680966
  NPD

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1952877995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4191 INNSLAKE DR STE 211",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603324",
            "telephone_number": "804-303-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4191 INNSLAKE DR STE 211",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603324",
            "telephone_number": "804-303-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANADA",
        "first_name": "EDWARD",
        "middle_name": "GAHAM",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-17",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701007956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon S Camden, MD PHD
• Campbell S. Delk, DDS, PC
• Amanda L Campbell, PH.D.
• Robert Lee Campbell, DDS
• Yvonne Campbell, LCSW
• Shannon Jeanette Cannon, C.P.N.P.
• Monicah Canty, FNP
• Heather E Capozzella, PT, DPT
• Caravati Counseling LLC
• Cardinal Pediatric Dentistry PLLC

• Mental Health Counselor in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.