Individual provider Active NPI

Lindsey Pace, LCSW

  • Clinical Social Worker
  • Clemmons, NC
National Provider Identifier
1457913170
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904011109 Issued in VA
Practice address
3540 Clemmons Rd Ste 110
Clemmons, NC 27012-9395
Phone
(757) 206-2824
NPI assigned
Jul 2, 2019
Last updated
Jun 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C015576 NC
Clinical Social Worker 1041C0700X 0904011109 VA Primary

Addresses

Primary practice location

3540 Clemmons Rd Ste 110
Clemmons, NC 27012-9395

Mailing address

3301 Richmond Hwy # 1153
Alexandria, VA 22305-3044
Phone (757) 206-2824

Other practice location 1

3301 Richmond Hwy # 1153
Alexandria, VA 22305-3044
Phone (757) 206-2824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 1, 2021 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C015576NCMDClinical Social Worker
0904011109VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lindsey Pace LCSW LLC Clinical CurrentSince Sep 1, 2021 Accepting new patients
Lindsey Pace LCSW LLC Clinical CurrentSince Sep 1, 2021 Accepting new patients
Psychotherapy Resources of Norfolk LTD Clinical PastSince Aug 15, 2019 Accepting new patients

Locations

3301 Richmond Hwy
Alexandria, VA 22305
Phone (571) 206-1121

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, 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": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1457913170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 RICHMOND HWY # 1153",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223053044",
            "telephone_number": "757-206-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 CLEMMONS RD STE 110",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129395",
            "telephone_number": "757-206-2824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3301 Richmond Hwy # 1153",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223053044",
            "country_code": "US",
            "telephone_number": "757-206-2824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACE",
        "first_name": "LINDSEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2023-06-22",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015576",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

Verify at the official NPI Registry.