Individual provider Active NPI

Christine D Delo, LCSW

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1477924397
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008616 Issued in VA
Practice address
297 Independence Blvd
Suite 126
Virginia Beach, VA 23462-2911
Phone
(757) 385-0511
Fax
(757) 497-6201
NPI assigned
Oct 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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 0904008616 VA Primary

Addresses

Primary practice location

297 Independence Blvd
Suite 126
Virginia Beach, VA 23462-2911

Mailing address

297 Independence Blvd
Suite 126
Virginia Beach, VA 23462-2911
Phone (757) 385-0511

Other identifiers 1

IdentifierTypeStateIssuer
1861562472MedicaidVA

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
I20160106000810 VA Practitioner - Clinical Social Worker 1153623210 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904008616VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Shore Community MH Mr Sas Services Board CurrentSince Oct 28, 2024 Accepting new patients
Eastern Shore Community Services Board CurrentSince Oct 28, 2024 Accepting new patients

Locations

19056 Greenbush Rd
Parksley, VA 23421
Phone (757) 665-1260

Organizations & group practices 2

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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Virginia Commonwealth Univ School of Dentistry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eastern Shore Community MH Mr Sas Services Board 17 clinicians

Practice addresses (Care Compare)

19056 Greenbush Rd
Parksley, VA 23421-2510
Phone (757) 665-1260

NPI Registry JSON

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1477924397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 INDEPENDENCE BLVD",
            "address_2": "SUITE 126",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234622911",
            "telephone_number": "757-385-0511",
            "fax_number": "757-497-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 INDEPENDENCE BLVD",
            "address_2": "SUITE 126",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234622911",
            "telephone_number": "757-385-0511",
            "fax_number": "757-497-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELO",
        "first_name": "CHRISTINE",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861562472",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.