| Mrs Kacie Michelle Zediker, LPC, ATR, CSOTP | |
| 
					7460 Central Business Park Dr, Norfolk, VA 23513-2818  | |
| (757) 644-6391 | |
| (757) 622-2011 | 
| Full Name | Mrs Kacie Michelle Zediker | 
|---|---|
| Gender | Female | 
| Speciality | Counselor - Mental Health | 
| Location | 7460 Central Business Park Dr, Norfolk, Virginia | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1922347814 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0701005414 (Virginia) | Primary | 
| Entity Name | Blu Orchard Therapy Of Washington | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1760217707 PECOS PAC ID: 0345778114 Enrollment ID: O20250107001478  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mrs Kacie Michelle Zediker, LPC, ATR, CSOTP 604 Fox Creek Ct, Virginia Beach, VA 23462-7138 Ph: (571) 212-4878  | Mrs Kacie Michelle Zediker, LPC, ATR, CSOTP 7460 Central Business Park Dr, Norfolk, VA 23513-2818 Ph: (757) 644-6391  | 
Kelly Patino Trejo, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 601 Childrens Ln, Norfolk, VA 23507 Phone: 757-668-7931 Fax: 757-668-9132  | |
Sonnee Da'niel Stanley, M.ED. Counselor Medicare: Not Enrolled in Medicare Practice Location: 9612 Wells Pkwy, Norfolk, VA 23503 Phone: 304-888-2910  | |
Ruth H Bybee, LPC Counselor Medicare: Medicare Enrolled Practice Location: 208 E Plume St Ste 327b, Norfolk, VA 23510 Phone: 757-637-0840  | |
Lauren P Jennings, LPC, LMFT, CEAP Counselor Medicare: Not Enrolled in Medicare Practice Location: 420 N Center Dr Suite 141, Interstate Corporate Center Building 11, Norfolk, VA 23502 Phone: 757-466-0700 Fax: 757-461-4826  | |
Ms. Susan Adams Niedenthal, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 6330 Newtown Rd, Suite 300, Norfolk, VA 23502 Phone: 757-466-3336 Fax: 757-455-5750  | |
Jamee Reese, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 850 Tidewater Dr, Ste. A, Norfolk, VA 23504 Phone: 757-533-9242  | |
Rachel Richardson,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 7460 Central Business Park Dr, Norfolk, VA 23513 Phone: 757-644-6391  |