Individual provider Active NPI

Pamela Jean Royalty, LCSW

  • Clinical Social Worker
  • Woodbridge, VA
National Provider Identifier
1003899295
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904004420 Issued in VA
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

Updated by the provider on Jul 8, 2007

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 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

LicenseStateTypeSpecialty
0904004420VAMDClinical 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.

Verify at the official NPI Registry.