Individual provider Active NPI

Rhiannon Davies-Hackenberg, LCSW

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1093798126
Registry record updated May 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904002438 Issued in VA
Practice address
256 N Witchduck Rd
Suite G
Virginia Beach, VA 23462-6544
Phone
(757) 497-3670
Fax
(757) 499-1947
NPI assigned
Nov 22, 2005
Last updated
May 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2014

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 0904002438 VA Primary

Addresses

Primary practice location

256 N Witchduck Rd
Suite G
Virginia Beach, VA 23462-6544

Mailing address

256 N Witchduck Rd
Suite G
Virginia Beach, VA 23462-6544
Phone (757) 497-3670

Other identifiers 1

IdentifierTypeStateIssuer
010082854MedicaidVA

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
I20040707000597 VA Practitioner - Clinical Social Worker 8325025356 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904002438VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Psychotherapy Services CurrentSince Jul 24, 2022 Accepting new patients
Thrive Counseling LLC CurrentSince May 15, 2020 Accepting new patients
Paradigm Health, LLC Past Accepting new patients

Locations

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

5310 Markel Rd
Ste 102
Richmond, VA 23230
Phone (804) 312-5498

260 Grayson Rd
Ste 100
Virginia Beach, VA 23462
Phone (757) 497-3670

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1400112000000",
    "number": "1093798126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 N WITCHDUCK RD",
            "address_2": "SUITE G",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626544",
            "telephone_number": "757-497-3670",
            "fax_number": "757-499-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 N WITCHDUCK RD",
            "address_2": "SUITE G",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626544",
            "telephone_number": "757-497-3670",
            "fax_number": "757-499-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIES-HACKENBERG",
        "first_name": "RHIANNON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2014-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904002438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010082854",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.