Individual provider Active NPI

Kathleen Lynch Miner, MSW, LCSW

  • Social Worker
  • Virginia Beach, VA
National Provider Identifier
1164746103
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
0904007322V Issued in VA
Practice address
3708 N Queensgrove Cir
Virginia Beach, VA 23452-3816
Phone
(757) 323-0660
NPI assigned
Mar 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 0904007322V VA Primary

Addresses

Primary practice location

3708 N Queensgrove Cir
Virginia Beach, VA 23452-3816

Mailing address

3708 N Queensgrove Cir
Virginia Beach, VA 23452-3816
Phone (757) 323-0660

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
I20110808000873 VA Practitioner - Clinical Social Worker 9133398118 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904007322VVAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Counseling Associates Inc CurrentSince Jan 1, 2025 Accepting new patients
Comprehensive Psychological Services PastSince Apr 1, 2023 Accepting new patients

Locations

9202 Center Oak Ct
Mechanicsvlle, VA 23116
Phone (804) 639-1112

780 Lynnhaven Pkwy
Ste 340
Virginia Beach, VA 23452
Phone (757) 301-8747

Organizations & group practices 2

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": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1164746103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 N QUEENSGROVE CIR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234523816",
            "telephone_number": "757-323-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 N QUEENSGROVE CIR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234523816",
            "telephone_number": "757-323-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINER",
        "first_name": "KATHLEEN",
        "middle_name": "LYNCH",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-19",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VA",
            "license": "0904007322V",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.