Look up the most recent NPI and PECOS records

Kandice Ketterling

Counselor

Behavioral Health & Social Service Providers

3410 Old Forest Rd, Lynchburg, VA 24501-2915

PECOS Enrollment

Based on the most recent information from CMS, provider Kandice Ketterling is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:51 AM.

Profile Details

Provider ID
1780165647
Provider Type
Individual
Full Name
Ketterling, Kandice
Gender
Female

Sole Proprietor
No
Enumeration Date
8/28/2018
Last Updated
8/28/2018

Contact Information

Practice Location

3410 Old Forest Rd, Lynchburg, VA 24501-2915

(434) 455-5342

Unlisted Fax

Mailing Location

3410 Old Forest Rd, Lynchburg, VA 24501-2915

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 0701007770 Virginia

Kandice Ketterling

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Roth, Nyomi S

Winebarger, Amanda

Stifler, Kenneth R

Haupt, Julie Rae

Rosenberg, Victoria

Edmonston, David B

Mental Health America Of Central Virginia

Daley, Derek

Conrad, Robin Carol

Cooper, Ethan R