Individual provider Active NPI

Christina Watty, LCSW

  • Clinical Social Worker
  • Radford, VA
National Provider Identifier
1093290223
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904010703 Issued in VA
Practice address
401 W Main St
Radford, VA 24141-1588
Phone
(540) 838-8000
Fax
(540) 961-8465
NPI assigned
Oct 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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 0904010703 VA Primary

Addresses

Primary practice location

401 W Main St
Radford, VA 24141-1588

Mailing address

700 University City Blvd
Blacksburg, VA 24060-2706
Phone (540) 961-8300

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
I20190201002316 VA Practitioner - Clinical Social Worker 3779820485 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904010703VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New River Valley Community Services CurrentSince Dec 1, 2018 Accepting new patients
New River Valley Community Services CurrentSince Dec 1, 2018 Accepting new patients

Locations

700 University City Blvd
Blacksburg, VA 24060
Phone (540) 961-8300

705 Wenonah Ave
Pearisburg, VA 24134
Phone (540) 921-2238

401 W Main St
Radford, VA 24141
Phone (540) 838-8000

Organizations & group practices 2

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": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1093290223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 UNIVERSITY CITY BLVD",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240602706",
            "telephone_number": "540-961-8300",
            "fax_number": "540-961-8465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W MAIN ST",
            "city": "RADFORD",
            "state": "VA",
            "postal_code": "241411588",
            "telephone_number": "540-838-8000",
            "fax_number": "540-961-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTY",
        "first_name": "CHRISTINA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Radford, VA

Sources for this page

Verify at the official NPI Registry.