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
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
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130822000077 | VA | Practitioner - Clinical Social Worker | 6103069182 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Ashland, VA · Mental Health Counselor in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.