Active NPI
Brenda Ingram Dandridge, LCSW
- Clinical Social Worker
- Richmond, VA
National Provider Identifier
1255475422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904002775
- Practice address
- 4825 S Laburnum Ave
Richmond, VA 23231-2713 - Phone
- (804) 222-2607
- Fax
- (804) 236-9118
- NPI assigned
- Feb 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904002775 | VA | Primary |
Addresses
Primary practice location
4825 S Laburnum Ave
Richmond, VA 23231-2713
Mailing address
10299 Woodman Rd
Glen Allen, VA 23060-4419
Phone (804) 727-8500
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 256538 | Other | VA | ANTHEM |
| 085717 | Other | VA | SENTARA |
| 2169321 | Other | VA | MAMSI |
| 263146-000 | Other | VA | MAGELLAN |
| 110295 | Other | VA | ANTHEM |
| 4945131 | Other | VA | VIRGINIA PREMIER |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295913600000",
"number": "1255475422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10299 WOODMAN RD",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230604419",
"telephone_number": "804-727-8500",
"fax_number": "804-727-8580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4825 S LABURNUM AVE",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232312713",
"telephone_number": "804-222-2607",
"fax_number": "804-236-9118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANDRIDGE",
"first_name": "BRENDA",
"middle_name": "INGRAM",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-19",
"last_updated": "2011-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904002775",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "256538",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA",
"identifier": "085717",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "2169321",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "263146-000",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "110295",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA PREMIER",
"identifier": "4945131",
"state": "VA"
}
],
"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 Jan 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.