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 2 days ago.

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

Harold, Alyssa

Taylor, Caitlin

Chrysanthus, Joann A

Evans, Jenna

Bullock, Callee

Oglesby, Christine E

Pitts, Jane E.

Crawford, Elizabeth Ann

Mace, Erin Sheetz

Wardlaw, Gary