Individual provider Active NPI

Bonnie Lucille Damron, L.C.S.W.

  • Clinical Social Worker
  • Falls Church, VA
National Provider Identifier
1386707024
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904001215 Issued in VA
Practice address
600 Roosevelt Blvd Apt G2
Falls Church, VA 22044-3129
Phone
(703) 538-4289
NPI assigned
Dec 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0904001215 VA Primary

Addresses

Primary practice location

600 Roosevelt Blvd Apt G2
Falls Church, VA 22044-3129

Mailing address

600 Roosevelt Blvd Apt G2
Falls Church, VA 22044-3129
Phone (703) 538-4289

Other identifiers 1

IdentifierTypeStateIssuer
0904001215OtherVASTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20060105000399 DC Practitioner - Clinical Social Worker 0749203784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

600 Roosevelt Blvd
Apt G2
Falls Church, VA 22044-3129
Phone (703) 538-6620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904001215VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bonnie L. Damron, PHD, MSW, PC Clinical CurrentSince Jul 21, 2012 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1166313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386707024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ROOSEVELT BLVD APT G2",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220443129",
            "telephone_number": "703-538-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ROOSEVELT BLVD APT G2",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220443129",
            "telephone_number": "703-538-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMRON",
        "first_name": "BONNIE",
        "middle_name": "LUCILLE",
        "name_prefix": "Dr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904001215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "0904001215",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.