Individual provider Active NPI

Malinda Tiffany, LCSW

  • Clinical Social Worker
  • Fishersville, VA
National Provider Identifier
1467996264
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090400803 Issued in VA
Practice address
79 N Medical Park Dr
Fishersville, VA 22939-2344
Phone
(540) 213-2525
Fax
(540) 213-2555
NPI assigned
Dec 13, 2016
Last updated
May 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 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 090400803 VA Primary

Addresses

Primary practice location

79 N Medical Park Dr
Fishersville, VA 22939-2344

Mailing address

PO Box 388
Fishersville, VA 22939-0388

Other practice location 1

1874 Anderson Hwy
Cumberland, VA 23040-2525
Phone (804) 836-9401

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
I20181102000004 VA Practitioner - Clinical Social Worker 4587917802 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Augusta Medical GroupGroup PAC ID 3678632544, 409 clinicians

Practice addresses (Care Compare)

79 N Medical Park Dr
Fishersville, VA 22939-2344
Phone (540) 213-2525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
090400803VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chesterfield Family Guidance Center Clinical CurrentSince Aug 19, 2018 Accepting new patients
Augusta Medical Group CurrentSince May 12, 2025 Accepting new patients
Augusta Medical Group CurrentSince May 12, 2025 Accepting new patients

Locations

53 S Medical Park Dr
Fishersville, VA 22939
Phone (540) 332-5687

79 N Medical Park Dr
Fishersville, VA 22939
Phone (540) 213-2525

6603 Irongate Sq
North Chesterfield, VA 23234

2166 Plainview Ctr
Powhatan, VA 23139

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14718/brand/4/csg/1/fhir/r4
  • Direct secure messaging: malinda.tiffany.1@14718.direct.athenahealth.com

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": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1467996264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229390388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 N MEDICAL PARK DR",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392344",
            "telephone_number": "540-213-2525",
            "fax_number": "540-213-2555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1874 Anderson Hwy",
            "address_purpose": "LOCATION",
            "city": "Cumberland",
            "state": "VA",
            "postal_code": "230402525",
            "country_code": "US",
            "telephone_number": "804-836-9401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIFFANY",
        "first_name": "MALINDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-13",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "090400803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

Verify at the official NPI Registry.