Individual provider Active NPI

Shaketa N L Draughn, LCSW

  • Clinical Social Worker
  • Richmond, VA
National Provider Identifier
1144749235
Registry record updated Sep 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904009937 Issued in VA
Practice address
2025 E Main St Ste 101
Richmond, VA 23223-7072
Phone
(804) 447-0193
Fax
(804) 562-1438
NPI assigned
Sep 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2017

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 0904009937 VA Primary

Addresses

Primary practice location

2025 E Main St Ste 101
Richmond, VA 23223-7072

Mailing address

5831 Kings Grove Dr
Chesterfield, VA 23832-7895
Phone (757) 921-0709

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904009937VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Specialized Solutions Family Services Current Accepting new patients

Locations

4121 Meadowdale Blvd
Ste C
North Chesterfield, VA 23234
Phone (804) 912-2458

Organizations & group practices 1

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": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505088000000",
    "number": "1144749235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5831 KINGS GROVE DR",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238327895",
            "telephone_number": "757-921-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 E MAIN ST STE 101",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232237072",
            "telephone_number": "804-447-0193",
            "fax_number": "804-562-1438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAUGHN",
        "first_name": "SHAKETA",
        "middle_name": "N L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2017-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009937",
            "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 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.