Individual
KELLY ELAINE VANDIVERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
406 CHATHAM SQ PARK, #102, FREDERICKSBURG, VA 22405-2585
(703) 819-7538
(540) 373-6266
Mailing address
186 BOULDER SPRINGS LN, LOUISA, VA 23093-6229
(540) 779-4334
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004449
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945247
—
VA
01
—
C02810
MEDICARE
VA
Enumeration date
11/26/2008
Last updated
06/19/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us