Freddie Dean Vines

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904002078 Issued in VA

Practice address

703 Thimble Shoals Blvd
A-3
Newport News, VA 23606-2576

Phone

(757) 873-2307

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Middle Peninsula Northern Neck Mental Health & Retardation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gloucester, VA
  • NPI 1497717615
  NPD (past)
• Therapy Associates of Denbigh, Inc

  • Mental Health Counselor
  • Newport News, VA
  • NPI 1336220938
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1366411290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8589 E CREEK LN",
            "city": "HAYES",
            "state": "VA",
            "postal_code": "230723748",
            "telephone_number": "757-873-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 THIMBLE SHOALS BLVD",
            "address_2": "A-3",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062576",
            "telephone_number": "757-873-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINES",
        "first_name": "FREDDIE",
        "middle_name": "DEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904002078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fnu Vikram, MD
• Ashlee K Villa, MA, LPC
• Village Doctor, P.C.
• Village Restoration
• Stacey Webber Villanueva
• Thao Leanne Vinh
• Koren Lea Virella, LCSW
• Virginia Anesthesia and Perioperative Care Specialists LLC
• Virginia Consumer-Directed Services
• Virginia CVS Pharmacy LLC

• Clinical Social Worker in Newport News, VA
• Providers in Newport News, 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 Jan 17, 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.

Verify at the official NPI Registry.