Individual provider Active NPI

Jacob Rheaume, LCSW

  • Clinical Social Worker
  • Richmond, VA
National Provider Identifier
1043725641
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904010179 Issued in VA
Practice address
5511 Staples Mill Rd Ste 300
Richmond, VA 23228-5445
Phone
(804) 230-0999
NPI assigned
Dec 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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 0904010179 VA Primary

Addresses

Primary practice location

5511 Staples Mill Rd Ste 300
Richmond, VA 23228-5445

Mailing address

5511 Staples Mill Rd Ste 300
Richmond, VA 23228-5445
Phone (804) 230-0999

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
I20180912000360 VA Practitioner - Clinical Social Worker 0244580256 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904010179VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
River City Integrative Counseling CurrentSince Aug 30, 2018 Accepting new patients
Starcity Behavioral Health LLC PastSince Mar 1, 2023 Accepting new patients
Chesterfield Counseling Group Past Accepting new patients

Locations

2604 N Parham Rd
Richmond, VA 23294
Phone (804) 237-4011

5511 Staples Mill Rd
Ste 300
Richmond, VA 23228
Phone (804) 681-2525

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": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1043725641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5511 STAPLES MILL RD STE 300",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232285445",
            "telephone_number": "804-230-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5511 STAPLES MILL RD STE 300",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232285445",
            "telephone_number": "804-230-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHEAUME",
        "first_name": "JACOB",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.