Scott Weston Mandeville, L.C.S.W., CS.O.T.P.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904002990 Issued in VA

Practice address

108 W College St
Bridgewater, VA 22812-1124

Phone

(540) 828-3663

Fax

(540) 828-2322

NPI assigned

Mar 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Bridgewater Counseling Services PC

  • Clinical Social Worker
  • Bridgewater, VA
  • NPI 1891959169
  Medicare reassignment NPD Authorized official
• Bridgewater Counseling Services, PC

  • Clinical Social Worker
  • Bridgewater, VA
  • NPI 1700017621
  NPD (past)

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1437110657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W COLLEGE ST",
            "city": "BRIDGEWATER",
            "state": "VA",
            "postal_code": "228121124",
            "telephone_number": "540-828-3663",
            "fax_number": "540-828-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W COLLEGE ST",
            "city": "BRIDGEWATER",
            "state": "VA",
            "postal_code": "228121124",
            "telephone_number": "540-828-3663",
            "fax_number": "540-828-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDEVILLE",
        "first_name": "SCOTT",
        "middle_name": "WESTON",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W., CS.O.T.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904002990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "462838",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891959169",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "828523000",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COM-PSYCH",
            "identifier": "219164",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "O86454M",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Webster Lassiter, EDD, ATC, CHES
• Barbara Long, ED.D, VATL, ATC
• Mitchel Lovinger, OT
• Alexis Mackey
• Jillian Paige Maddra
• Patrick Massey
• Arlene S McCain, MD
• Maureen Patricia McCann, RDH,BSDH
• McIntyre & Whiting PC
• McIntyre & Whiting PC

• Clinical Social Worker in Bridgewater, VA
• Providers in Bridgewater, 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 Dec 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.
• 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.