Individual provider Active NPI

Jennifer Michelle Bivins, SCSW

  • Clinical Social Worker
  • Colonial Heights, VA
National Provider Identifier
1487545364
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0906015853 Issued in VA
Practice address
955 Edinborough Dr
Colonial Heights, VA 23834-2611
Phone
(804) 586-2647
NPI assigned
Jul 10, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 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 0906015853 VA Primary

Addresses

Primary practice location

955 Edinborough Dr
Colonial Heights, VA 23834-2611

Mailing address

955 Edinborough Dr
Colonial Heights, VA 23834-2611
Phone (804) 586-2647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0906015853VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1487545364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 EDINBOROUGH DR",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342611",
            "telephone_number": "804-586-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 EDINBOROUGH DR",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342611",
            "telephone_number": "804-586-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIVINS",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "credential": "SCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0906015853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.