Active NPI
Pamela Jean Royalty, LCSW
- Clinical Social Worker
- Woodbridge, VA
National Provider Identifier
1003899295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904004420
- Practice address
- 14450 Smoketown Rd
Woodbridge Behavioral Health Clinic
Woodbridge, VA 22192-4712 - Phone
- (703) 551-4720
- NPI assigned
- Nov 22, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904004420 | VA | Primary |
Addresses
Primary practice location
14450 Smoketown Rd
Woodbridge Behavioral Health Clinic
Woodbridge, VA 22192-4712
Mailing address
12350 Pond Run Dr
Woodbridge, VA 22192-7070
Phone (703) 551-4720
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904004420 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003899295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12350 POND RUN DR",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221927070",
"telephone_number": "703-551-4720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14450 SMOKETOWN RD",
"address_2": "WOODBRIDGE BEHAVIORAL HEALTH CLINIC",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221924712",
"telephone_number": "703-551-4720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROYALTY",
"first_name": "PAMELA",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904004420",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.