David Michael Canada Jr., LCSW

Individual provider Active NPI Mental Health Counselor · Ashland, VA

NPI 1972940955 · NPPES record last updated May 30, 2013

Key facts

NPI
1972940955
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
0904008191 (VA)
Practice address
12300 Washington Hwy
Ashland, VA 23005-7646
Phone
(804) 365-4222
Fax
(804) 365-4252
NPI assigned
May 30, 2013
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Virginia Commonwealth University, School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hanover County Board of Supervisors (16 clinicians)

Practice addresses (Care Compare)

12300 Washington Hwy
Ashland, VA 23005-7646
Phone (804) 365-4222

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20130822000077 VA Practitioner - Clinical Social Worker 6103069182 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0904008191 VA Yes

Addresses

Primary practice location

12300 Washington Hwy
Ashland, VA 23005-7646

Mailing address

12300 Washington Hwy
Ashland, VA 23005-7646
Phone (804) 365-4222

Other providers in Ashland, VA

All providers in Ashland, VA · Mental Health Counselor in Virginia

Sources for this page

Verify at the official NPI Registry.