Individual provider Active NPI

Ehren Michael Flynn

  • Clinical Social Worker
  • Midlothian, VA
National Provider Identifier
1366562092
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008540 Issued in VA
Practice address
5102 W Village Green Dr Ste 102
Midlothian, VA 23112-4876
Phone
(804) 743-0960
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904008540 VA Primary

Addresses

Primary practice location

5102 W Village Green Dr Ste 102
Midlothian, VA 23112-4876

Mailing address

2512 Tanglebrook Rd
Midlothian, VA 23112-4049
Phone (804) 971-3964

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220907001232 VA Practitioner - Clinical Social Worker 0941341713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chesterfield Family Guidance CenterGroup PAC ID 5799762712, 40 clinicians

Practice addresses (Care Compare)

5102 W Village Green Dr
Suite 102
Midlothian, VA 23112-4876
Phone (804) 743-0960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chesterfield Family Guidance Center Clinical CurrentSince Aug 24, 2022 Accepting new patients
Northeast Behavioral Health Corporation PastSince May 8, 2017 Accepting new patients

Locations

5102 W Village Green Dr
Ste 102
Midlothian, VA 23112

6603 Irongate Sq
North Chesterfield, VA 23234

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1366562092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 TANGLEBROOK RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124049",
            "telephone_number": "804-971-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5102 W VILLAGE GREEN DR STE 102",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124876",
            "telephone_number": "804-743-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "EHREN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.