Individual provider Active NPI

Katelyn Sisson

  • Clinical Social Worker
  • North Chesterfield, VA
National Provider Identifier
1003613050
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
8310 Midlothian Tpke
North Chesterfield, VA 23235-5163
Phone
(804) 447-6382
NPI assigned
Feb 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

8310 Midlothian Tpke
North Chesterfield, VA 23235-5163

Mailing address

8310 Midlothian Tpke
North Chesterfield, VA 23235-5163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250408003308 VA Practitioner - Clinical Social Worker 6608390935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lighthouse Behavioral Health Center, LLCGroup PAC ID 5092021949, 22 clinicians

Practice addresses (Care Compare)

8310 Midlothian Tpke
North Chesterfield, VA 23235-5163
Phone (804) 447-6382

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Behavioral Health Center, LLC Clinical CurrentSince Mar 21, 2025 Accepting new patients

Locations

8310 Midlothian Tpke
North Chesterfield, VA 23235
Phone (804) 447-6382

Networks

  • TN PPO C-SNP
  • KY PPO
  • KY PPO C-SNP
  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1
  • TN PPO

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1003613050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8310 MIDLOTHIAN TPKE",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232355163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8310 MIDLOTHIAN TPKE",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232355163",
            "telephone_number": "804-447-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISSON",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

Verify at the official NPI Registry.