Individual provider Active NPI

Daniel Robert Cimo, LCSW

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1376354639
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904017607 Issued in VA
Practice address
904 Dwyer CT
Virginia Beach, VA 23454-6915
Phone
(757) 617-5461
NPI assigned
Jan 16, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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 0904017607 VA Primary

Addresses

Primary practice location

904 Dwyer CT
Virginia Beach, VA 23454-6915

Mailing address

904 Dwyer CT
Virginia Beach, VA 23454-6915
Phone (757) 617-5461

Other practice location 1

5248 Olde Towne Rd Ste 10
Williamsburg, VA 23188-1986
Phone (757) 603-4603

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
I20250227003101 VA Practitioner - Clinical Social Worker 8022538438 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904017607VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Abundant Life Partners, LLC Clinical CurrentSince Jan 22, 2025 Accepting new patients
Abundant Path LLC Clinical PastSince Sep 28, 2025 Accepting new patients

Locations

5248 Olde Towne Rd
Ste 10
Williamsburg, VA 23188

1315 Jamestown Rd
Ste 203
Williamsburg, VA 23185

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": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1376354639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 DWYER CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234546915",
            "telephone_number": "757-617-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 DWYER CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234546915",
            "telephone_number": "757-617-5461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5248 Olde Towne Rd Ste 10",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231881986",
            "country_code": "US",
            "telephone_number": "757-603-4603",
            "fax_number": "757-257-9146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIMO",
        "first_name": "DANIEL",
        "middle_name": "ROBERT",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904017607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.