Organization Active NPI

Betty Eastman LCSW and Associates Inc

  • Clinical Social Worker
  • Poquoson, VA
National Provider Identifier
1265609887
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904004680 Issued in VA
Legal business name
BETTY EASTMAN LCSW AND ASSOCIATES INC
Practice address
200 City Hall Ave
Suite E
Poquoson, VA 23662-1985
Phone
(757) 868-0072
NPI assigned
May 13, 2008
Last updated
Dec 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Authorized official

Name
Betty Eastman, LCSWNPI 1578532461
Title
President
Phone
(757) 868-0072

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 0904004680 VA Primary

Addresses

Primary practice location

200 City Hall Ave
Suite E
Poquoson, VA 23662-1985

Mailing address

200 City Hall Ave
Suite E
Poquoson, VA 23662-1985
Phone (757) 868-0072

Other identifiers 2

IdentifierTypeStateIssuer
428878OtherVATRICARE
356288OtherVABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080724000696 VA Part B Supplier - Clinic/Group Practice 6002989928 Receives reassigned benefits from 2 practitioners
Practice locations: Poquoson, VA

National Provider Directory

National Provider Directory

Locations

200 City Hall Ave
Ste E
Poquoson, VA 23662
Phone (757) 868-0072

360 Wythe Creek Rd
Ste C
Poquoson, VA 23662
Phone (757) 868-0072

370C Wythe Creek Rd
Poquoson, VA 23662

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228176000000",
    "number": "1265609887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CITY HALL AVE",
            "address_2": "SUITE E",
            "city": "POQUOSON",
            "state": "VA",
            "postal_code": "236621985",
            "telephone_number": "757-868-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CITY HALL AVE",
            "address_2": "SUITE E",
            "city": "POQUOSON",
            "state": "VA",
            "postal_code": "236621985",
            "telephone_number": "757-868-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETTY EASTMAN LCSW AND ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-12-02",
        "status": "A",
        "authorized_official_last_name": "EASTMAN",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-868-0072",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904004680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "428878",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "356288",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poquoson, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.