Misty Dawn Vance, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904011249 Issued in VA

Practice address

113 Cumberland Road
Cedar Bluff, VA 24609

Phone

(276) 964-6702

Fax

(276) 964-0292

NPI assigned

Oct 21, 2019

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 names 1

• Misty Dawn Kiser Former name

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Cumberland Mountain Community Services

  • Community/Behavioral Health Agency
  • Cedar Bluff, VA
  • NPI 1235125055
  Medicare reassignment NPD

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1265075493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "246090810",
            "telephone_number": "276-964-6702",
            "fax_number": "276-964-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 CUMBERLAND ROAD",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "24609",
            "telephone_number": "276-964-6702",
            "fax_number": "276-964-0292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "78 Rogers Street",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "VA",
            "postal_code": "24266",
            "country_code": "US",
            "telephone_number": "276-889-3785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "578 Main Street",
            "address_purpose": "LOCATION",
            "city": "Tazewell",
            "state": "VA",
            "postal_code": "24651",
            "country_code": "US",
            "telephone_number": "276-988-7961",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1014 Stillhouse Hollow Road",
            "address_purpose": "LOCATION",
            "city": "Grundy",
            "state": "VA",
            "postal_code": "24614",
            "country_code": "US",
            "telephone_number": "276-935-7154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "216 Gilmer Street",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "VA",
            "postal_code": "24266",
            "country_code": "US",
            "telephone_number": "276-964-6702",
            "fax_number": "276-964-0292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANCE",
        "first_name": "MISTY",
        "middle_name": "DAWN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISTY",
            "last_name": "KISER",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Courtney Amanda Taylor, LPC
• Tiffany Lynn Thebeau
• Debra Janine Thomas, MD
• Kristen Denise Thompson-Whitt, MSN, APRN, FNP
• Justin Craig Trout, LPC
• Victory Transports Inc
• Krista Vilacha
• Vital Care of Southwest Virginia, Inc. (Vital Care of Southwest Virginia)
• Vital Care Southwest VA, Inc
• Vital Care Southwest Virginia, Inc.

• Clinical Social Worker in Cedar Bluff, VA
• Providers in Cedar Bluff, 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 Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.