Active NPI
Janice V. Atwell, LCSW
- Clinical Social Worker
- Providence Forge, VA
National Provider Identifier
1366587396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904003596
- Practice address
- 9403 Pocohantas Trail
Providence Forge, VA 23140 - Phone
- (804) 966-5959
- Fax
- (804) 966-5694
- NPI assigned
- Feb 20, 2007
- 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 | 0904003596 | VA | Primary |
Addresses
Primary practice location
9403 Pocohantas Trail
Providence Forge, VA 23140
Mailing address
10299 Woodman Rd
Glen Allen, VA 23060-4419
Phone (804) 727-8500
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 081159 | Other | VA | SENTARA |
| 082997 | Other | VA | SENTARA |
| 4945131 | Other | VA | VIRGINIA PREMIER |
| 7123403 | Other | VA | MAMSI |
| 216958 | Other | VA | ANTHEM |
| 263250-000 | Other | VA | MAGELLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904003596 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347494400000",
"number": "1366587396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10299 WOODMAN RD",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230604419",
"telephone_number": "804-727-8500",
"fax_number": "804-727-8580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9403 POCOHANTAS TRAIL",
"city": "PROVIDENCE FORGE",
"state": "VA",
"postal_code": "23140",
"telephone_number": "804-966-5959",
"fax_number": "804-966-5694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATWELL",
"first_name": "JANICE",
"middle_name": "V.",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2012-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904003596",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA",
"identifier": "081159",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA",
"identifier": "082997",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA PREMIER",
"identifier": "4945131",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "7123403",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "216958",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "263250-000",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Providence Forge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.