Eileen E Gannon, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904002407 Issued in VA

Practice address

6801 Lucy Corr CT
Chesterfield, VA 23832-6657

Phone

(804) 748-1227

Fax

(804) 717-6659

NPI assigned

Feb 20, 2007

Last updated

May 6, 2016By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Chesterfield County Mental Health

  • Community/Behavioral Health Agency
  • Chesterfield, VA
  • NPI 1538605613
  NPD (past)
• Chesterfield County Mental Health

  • Nursing Care Agency
  • Chesterfield, VA
  • NPI 1609253897
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1184769135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 LUCY CORR CT",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326657",
            "telephone_number": "804-748-1227",
            "fax_number": "804-717-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 LUCY CORR CT",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326657",
            "telephone_number": "804-748-1227",
            "fax_number": "804-717-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "EILEEN",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904002407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336293000",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laquina Fulton Garvin, LCSW
• Joshua Cole Funk, MSOTR/L
• Sheila Mary Furey, MD
• Melissa Maney Futrell, RN
• Paula Futrell
• Tonora Garbutt, DNP
• Brandy Gardner, PSYD
• Emily Garnett
• John Howard Garrett II
• Gateway Homes, Inc.

• Clinical Social Worker in Chesterfield, VA
• Providers in Chesterfield, 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 May 6, 2016; 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.