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David B Edmonston

Counselor

Behavioral Health & Social Service Providers

2215 Langhorne Rd, Lynchburg, VA 24501-1121

PECOS Enrollment

This provider is enrolled in PECOS as DAVID EDMONSTON.

Based on the most recent information from CMS, provider David B Edmonston 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
1982705380
Provider Type
Individual
Full Name
Edmonston, David B
Credential
LPC

Gender
Male
Sole Proprietor
No
Enumeration Date
9/26/2006
Last Updated
11/18/2024

Contact Information

Practice Location

2215 Langhorne Rd, Lynchburg, VA 24501-1121

(434) 948-4831

Unlisted Fax

Mailing Location

2215 Langhorne Rd, Lynchburg, VA 24501-1121

(434) 948-4831

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 0701003337 Virginia

Provider Identifiers

ID	Description	Issuer
ID 245525	Description Other	Issuer ANTHEM BLUE SHIELD Virginia
ID 004945441	Description Medicaid	Issuer Unlisted Virginia
ID O89787	Description Other	Issuer SENTARA Virginia

David B Edmonston

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Roth, Nyomi S

Kee, Joshua

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Hart, Mary E

Smith, Jennifer

Smith, Lisa L

Beck, Mark W

Tucker, Amy Billingsly

Thomas, Nicole

Hodge, Gerrie Luann