Individual provider Active NPI

Byra Ciccolo, MSW

  • Clinical Social Worker
  • Midlothian, VA
National Provider Identifier
1447985296
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
5712 Oak Knoll Rd
Midlothian, VA 23112-2400
Phone
(804) 608-9704
Fax
(855) 700-5573
NPI assigned
Jul 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 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 Primary

Addresses

Primary practice location

5712 Oak Knoll Rd
Midlothian, VA 23112-2400

Mailing address

5712 Oak Knoll Rd
Midlothian, VA 23112-2400
Phone (804) 608-9704

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
I20251030004886 VA Practitioner - Clinical Social Worker 5698264455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aevum BH VA LLC 35 clinicians

Practice addresses (Care Compare)

1719 Bellevue Ave
Richmond, VA 23227-3901
Phone (804) 446-1710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aevum BH VA LLC Clinical CurrentSince Oct 13, 2025 Accepting new patients
Innovative Care LLC Clinical CurrentSince Jul 24, 2022 Accepting new patients
Aevum Behavioral Health VA LLC Clinical PastSince Sep 1, 2024 Accepting new patients

Locations

1108 E Main St
Ste 701
Richmond, VA 23219
Phone (540) 538-7694

1719 Bellevue Ave
Richmond, VA 23227
Phone (804) 262-7364

4403 Forest Hill Ave
Richmond, VA 23225
Phone (804) 231-0231

Organizations & group practices 3

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": "1658016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1447985296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5712 OAK KNOLL RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122400",
            "telephone_number": "804-608-9704",
            "fax_number": "855-700-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5712 OAK KNOLL RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122400",
            "telephone_number": "804-608-9704",
            "fax_number": "855-700-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCOLO",
        "first_name": "BYRA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-17",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.