Active NPI
Debra L. Berryman, LCSW
- Clinical Social Worker
- Lawrenceville, VA
National Provider Identifier
1306869169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904005542
- Practice address
- 2087 Lawrenceville Plank Road
Lawrenceville, VA 23868 - Phone
- (434) 848-4121
- Fax
- (434) 848-4148
- NPI assigned
- Jul 25, 2006
- Last updated
- Apr 3, 2008
- 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 | 0904005542 | VA | Primary |
Addresses
Primary practice location
2087 Lawrenceville Plank Road
Lawrenceville, VA 23868
Mailing address
PO Box 488
South Boston, VA 24592-0488
Phone (434) 848-4121
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 466131 | Other | VA | ANTHEM - MECK |
| 466127 | Other | VA | ANTHEM |
| 1700890761 | Medicaid | VA | |
| 466135 | Other | VA | ANTHEM - HALIFAX |
| O81326M | Other | VA | SENTARA |
Other names 1
- Ms. Debra L. Shorter
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904005542 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207180800000",
"number": "1306869169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 488",
"city": "SOUTH BOSTON",
"state": "VA",
"postal_code": "245920488",
"telephone_number": "434-848-4121",
"fax_number": "434-572-4881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2087 LAWRENCEVILLE PLANK ROAD",
"city": "LAWRENCEVILLE",
"state": "VA",
"postal_code": "23868",
"telephone_number": "434-848-4121",
"fax_number": "434-848-4148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRYMAN",
"first_name": "DEBRA",
"middle_name": "L.",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2008-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904005542",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM - MECK",
"identifier": "466131",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "466127",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1700890761",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM - HALIFAX",
"identifier": "466135",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA",
"identifier": "O81326M",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DEBRA",
"last_name": "SHORTER",
"middle_name": "L.",
"prefix": "MS.",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lawrenceville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.