Laura Caitlin Mangelsdorf, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904018571 Issued in VA

Practice address

1158 Professional Dr Ste G
Williamsburg, VA 23185-6618

Phone

(757) 713-6017

NPI assigned

Aug 18, 2025

Last updated

Aug 18, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Authentic Self Association LLCGroup PAC ID 7911422407, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Authentic Self Association LLC

  • Clinical Social Worker
  • Williamsburg, VA
  • NPI 1720854466
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1437036944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1158 PROFESSIONAL DR STE G",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231856618",
            "telephone_number": "757-713-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1158 PROFESSIONAL DR STE G",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231856618",
            "telephone_number": "757-713-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGELSDORF",
        "first_name": "LAURA",
        "middle_name": "CAITLIN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904018571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siham Mohieldin Mahgoub, MD
• Kimberly Dianne Maigi, NP
• James Patrick Majdic, DO
• Adrian Mallicott, LPTA
• Islam Mallory
• Justin Mangold
• Lauren Maninga, LCSW
• Hannah Lee Manson, PA
• Patricia L Marcuson, M.D.
• Sanford Kent Marcuson, M.D.

• Clinical Social Worker in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.