Individual provider Active NPI

Philisha Woodard, LCSW

  • Clinical Social Worker
  • Williamsburg, VA
National Provider Identifier
1023601812
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904012683 Issued in VA
Practice address
1117 Old Colony LN Ste a
Williamsburg, VA 23185-3801
Phone
(757) 204-5928
NPI assigned
Feb 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2023

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 0904012683 VA Primary

Addresses

Primary practice location

1117 Old Colony LN Ste a
Williamsburg, VA 23185-3801

Mailing address

1117 Old Colony LN Ste a
Williamsburg, VA 23185-3801
Phone (757) 204-5928

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
I20210325000422 VA Practitioner - Clinical Social Worker 9133536840 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Peninsula-Northern Neck Mental Health and Mental Retardation CurrentSince Feb 19, 2021 Accepting new patients
Woodard Healing Center, LLC Clinical CurrentSince Sep 9, 2024 Accepting new patients
Middle Peninsula Northern Neck Mental Health & Retardation CurrentSince Feb 19, 2021 Accepting new patients

Locations

9228 George Washington Memorial Hwy
Gloucester, VA 23061
Phone (804) 693-5057

1041 Sharon Rd
Ste 201
King William, VA 23086
Phone (804) 769-2751

330 Hospital Rd
Tappahannock, VA 22560
Phone (804) 695-8120

1117 Old Colony Ln
#A
Williamsburg, VA 23185
Phone (757) 204-5928

Organizations & group practices 3

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": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1023601812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 OLD COLONY LN STE A",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231853801",
            "telephone_number": "757-204-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 OLD COLONY LN STE A",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231853801",
            "telephone_number": "757-204-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "PHILISHA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-12",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904012683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.