Individual provider Active NPI

Derek John Macfarlane

  • Clinical Social Worker
  • Richmond, VA
National Provider Identifier
1114696978
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904019435 Issued in VA
Practice address
3900 W Broad St
Richmond, VA 23230-3914
Phone
(804) 353-4461
NPI assigned
Sep 7, 2021
Reactivated
Sep 15, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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 0904019435 VA Primary

Addresses

Primary practice location

3900 W Broad St
Richmond, VA 23230-3914

Mailing address

3900 W Broad St
Richmond, VA 23230-3914
Phone (804) 353-4461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1114696978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 W BROAD ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303914",
            "telephone_number": "804-353-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W BROAD ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303914",
            "telephone_number": "804-353-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACFARLANE",
        "first_name": "DEREK",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-07",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "deactivation_date": "2026-09-10",
        "reactivation_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904019435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.