Brinda Fowlkes, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904002272 Issued in VA

Practice address

1492 Springfield Rd
Meherrin, VA 23954-2222

Phone

(434) 736-8369

Fax

(434) 736-8602

NPI assigned

Jul 28, 2014

Last updated

Jul 28, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Meherrin Transportation LLC

  • Non-emergency Medical Transport (VAN)
  • Meherrin, VA
  • NPI 1568848935
  NPD (past) Authorized official

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406505600000",
    "number": "1174931786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1492 SPRINGFIELD RD",
            "city": "MEHERRIN",
            "state": "VA",
            "postal_code": "239542222",
            "telephone_number": "434-736-8369",
            "fax_number": "434-736-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 SPRINGFIELD RD",
            "city": "MEHERRIN",
            "state": "VA",
            "postal_code": "239542222",
            "telephone_number": "434-736-8369",
            "fax_number": "434-736-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLKES",
        "first_name": "BRINDA",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2014-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904002272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Dail Baker, FNP, RN
• Tracy Childress
• Adrieana Kirby
• Meherrin Transportation LLC
• Meherrin Volunteer Fire & Rescue Inc Engine Co No 5 (Meherrin Volunteer Fire & Rescue Inc)
• Susan Leslie Sisler, LPC
• Brandi Trace, MA, LPC-R

• Clinical Social Worker in Meherrin, VA
• Providers in Meherrin, 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 28, 2014; 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.