Individual provider Active NPI

Deborah Lynn Daniel, L.C.S.W.

  • Clinical Social Worker
  • Midlothian, VA
National Provider Identifier
1104907104
Registry record updated Dec 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904002044 Issued in VA
Practice address
1133 Jefferson Green Cir
Midlothian, VA 23113-4300
Phone
(804) 717-1111
Fax
(804) 717-1185
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2044 VA
Clinical Social Worker 1041C0700X 0904002044 VA Primary

Addresses

Primary practice location

1133 Jefferson Green Cir
Midlothian, VA 23113-4300

Mailing address

PO Box 555
Midlothian, VA 23113-0555
Phone (804) 717-1111

Other identifiers 2

IdentifierTypeStateIssuer
1104907104MedicaidVA
190000809OtherVAMEDICARE

Other names 1

  • Mrs. Deborah Lynn Daniel Professional name

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
I20110622000744 VA Practitioner - Clinical Social Worker 8325226384 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2044VAMDMental Health Counselor
0904002044VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerment Counseling, LLC Clinical CurrentSince Jul 10, 2018 Accepting new patients
Three Rivers Treatment Center LLC Past Accepting new patients
Central Virginia Family Psychiatry PC Past Accepting new patients
Virginia South Psychiatric & Family Services PastSince Aug 26, 2002 Accepting new patients

Locations

1133 Jefferson Green Cir
Midlothian, VA 23113
Phone (804) 717-1111

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72142

Organizations & group practices 5

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324166400000",
    "number": "1104907104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231130555",
            "telephone_number": "804-717-1111",
            "fax_number": "804-717-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 JEFFERSON GREEN CIR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231134300",
            "telephone_number": "804-717-1111",
            "fax_number": "804-717-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "DEBORAH",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2011-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "2044",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904002044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104907104",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "190000809",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "DANIEL",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.