Chidera B Anumudu

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904016976 Issued in VA

Practice address

11835 Hazel Circle Dr
Bristow, VA 20136-1223

Phone

(703) 659-9900

NPI assigned

Jul 1, 2024

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Youth for Tomorrow New Life Center, Inc.

  • Psychiatric Residential Treatment Facility
  • Bristow, VA
  • NPI 1316118292
  NPD

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1114763067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7376 ROUTE 29 UNIT 104",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220464766",
            "telephone_number": "919-457-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 HAZEL CIRCLE DR",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201361223",
            "telephone_number": "703-659-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANUMUDU",
        "first_name": "CHIDERA",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904016976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanise Signoret Allen, LCSW
• Mohammad A. Amiri Sr.
• Esther Oduraa Amoo
• Kenneth Amoo
• Antoinette Place LLC
• Apex DME Billing LLC
• Meseret Asfaw
• Associates in Eyecare Bristow PC
• Awareness Lounge Counseling, LLC
• Back 2 Back Chiropractic (Braemar Village Chiropractic)

• Clinical Social Worker in Bristow, VA
• Providers in Bristow, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.