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KELLY ELAINE VANDIVERT LPC
NPI 1578718987
Counselor - Professional in Fredericksburg, VA

Active since November 26, 2008PECOS EnrolledAccepts Medicare Assignment
406 CHATHAM SQ PARK, #102, FREDERICKSBURG, VA 22405(703) 819-7538(540) 373-6266 Get Directions Write a Review

NPPES record last updated: June 19, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kelly Elaine Vandivert Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY ELAINE VANDIVERT LPC (NPI 1578718987) is an individual professional provider in Fredericksburg, Virginia, licensed in Virginia (0701004449) and active in the NPI registry since November 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2005).

NPPES Registry Identity

NPI1578718987
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKELLY ELAINE VANDIVERTCredential: LPC
Location Address406 CHATHAM SQ PARK, #102Fredericksburg, VA 22405-2585
Mailing Address186 Boulder Springs LnLouisa, VA 23093-6229 · (540) 779-4334
Phone(703) 819-7538
Fax(540) 373-6266
Sole ProprietorYes
Medical School CMSOtherGraduated 2005
Enumeration DateNovember 26, 2008
Last NPPES UpdateJune 19, 2024
NPPES CertifiedJune 19, 2024
✔ NPI 1578718987 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in VA · 0701004449
406 CHATHAM SQ PARK, Fredericksburg, VA 22405
Open in Google Maps ↗

Other Identifiers 2

Medicaid004945247VA
OtherC02810VA · Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Florida, Inc., Florida Blue (BlueCross BlueShield FL) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Elaine Vandivert Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567909104
PECOS Enrollment IDI20240801000317
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Kelly Vandivert reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mccd Fl Psychiatry Services PA
601 mi
Psychiatry
1301 RIVERPLACE BLVD STE 800
Jacksonville, FL 32207
  • Reassigned Medicare billing, District of Columbia and Virginia enrollments
  • 76 clinicians in this Medicare group
NPI 1659003457 (833) 351-8255
Deer Oaks Southeast LLC
1,353 mi
Clinical
7272 WURZBACH RD, SUITE 601
San Antonio, TX 78240
  • Reassigned Medicare billing, Virginia enrollment
  • 29 clinicians in this Medicare group
NPI 1619112612 (210) 615-8880

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 30 minutes 90832
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 30-minute session, the therapist helps you explore feelings, thoughts, and behaviors to better understand yourself and manage life's challenges.
50 services11 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Vandivert's NPI number?

The NPI number for Kelly Vandivert is 1578718987. It was assigned to this individual provider in the NPPES registry on November 26, 2008.

Where is Kelly Vandivert located?

Kelly Vandivert practices at 406 Chatham Sq Park #102, Fredericksburg, VA 22405. The listed phone number is (703) 819-7538.

What is Kelly Vandivert's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kelly Vandivert enrolled in Medicare?

Yes. Kelly Vandivert is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kelly Vandivert's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Vandivert reassigns Medicare benefits to 2 organizations: Mccd Fl Psychiatry Services PA (Jacksonville, FL) and Deer Oaks Southeast LLC (San Antonio, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Vandivert's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Vandivert accept?

Health plans from Cigna HealthCare of Florida, Inc., Cigna Healthcare, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Oscar Health and 1 other insurer list Kelly Vandivert as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly Vandivert was last updated on June 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.