Individual provider Active NPI

Danielle Christina Nieto, LCSW

  • Clinical Social Worker
  • Fredericksburg, VA
National Provider Identifier
1154893147
Registry record updated Jan 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904009112 Issued in VA
Practice address
4528 Plank Rd # A1
Fredericksburg, VA 22407-0141
Phone
(540) 845-6490
NPI assigned
Jan 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 0904009112 VA Primary

Addresses

Primary practice location

4528 Plank Rd # A1
Fredericksburg, VA 22407-0141

Mailing address

6506 Crittenden LN
Spotsylvania, VA 22553-1893
Phone (540) 429-4347

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
I20240409002390 VA Practitioner - Clinical Social Worker 4789022864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Youth for Tomorrow New Life Center IncGroup PAC ID 1951673227, 15 clinicians

Practice addresses (Care Compare)

14000 Crown CT
Suite 101
Woodbridge, VA 22193-1461
Phone (703) 659-9900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904009112VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Youth for Tomorrow New Life Center, Inc. Multi-Specialty CurrentSince Jan 20, 2024 Accepting new patients

Locations

11835 Hazel Circle Dr
Bristow, VA 20136
Phone (703) 368-7995

3800 Fettler Park Dr
Ste 103
Dumfries, VA 22025

14000 Crown Ct
Ste 101
Woodbridge, VA 22193
Phone (703) 659-9900

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": "1546300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546300800000",
    "number": "1154893147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6506 CRITTENDEN LN",
            "city": "SPOTSYLVANIA",
            "state": "VA",
            "postal_code": "225531893",
            "telephone_number": "540-429-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4528 PLANK RD # A1",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224070141",
            "telephone_number": "540-845-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETO",
        "first_name": "DANIELLE",
        "middle_name": "CHRISTINA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-01",
        "last_updated": "2019-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.