Individual provider Active NPI

Misty Lee Woodard, RBA, LICSW

  • Clinical Social Worker
  • Charleston, WV
National Provider Identifier
1376255265
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
DP00946585 Issued in WV
Practice address
1 Kenton Dr Ste 200
Charleston, WV 25311-1256
Phone
(304) 513-3495
NPI assigned
Dec 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X DP00946585 WV Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X

Addresses

Primary practice location

1 Kenton Dr Ste 200
Charleston, WV 25311-1256

Mailing address

1005 White Willow Way
Morgantown, WV 26505-6119
Phone (304) 513-3495

Other practice location 1

101 Martin Dr
Mount Hope, WV 25880-1509
Phone (681) 422-3338

Other practice location 2

379 Stanaford Rd
Beckley, WV 25801-3141
Phone (681) 422-3338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20260408000701 WV Practitioner - Clinical Social Worker 1254806201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grandw IncGroup PAC ID 9739324922, 93 clinicians

Practice addresses (Care Compare)

1 Kenton Dr
Suite 200
Charleston, WV 25311-1256
Phone (304) 460-5123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DP00946585WVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
GR&W, Inc CurrentSince Jan 1, 2013 Accepting new patients
GR&W, Inc PastSince Apr 13, 2025 Accepting new patients

Locations

1 Kenton Dr
#200
Charleston, WV 25311
Phone (304) 408-3292

1005 White Willow Way
Morgantown, WV 26505
Phone (304) 212-7238

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": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1376255265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 WHITE WILLOW WAY",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265056119",
            "telephone_number": "304-513-3495",
            "fax_number": "800-734-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KENTON DR STE 200",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111256",
            "telephone_number": "304-513-3495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Martin Dr",
            "address_purpose": "LOCATION",
            "city": "Mount Hope",
            "state": "WV",
            "postal_code": "258801509",
            "country_code": "US",
            "telephone_number": "681-422-3338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "379 Stanaford Rd",
            "address_purpose": "LOCATION",
            "city": "Beckley",
            "state": "WV",
            "postal_code": "258013141",
            "country_code": "US",
            "telephone_number": "681-422-3338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "MISTY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "RBA, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00946585",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.