Active NPI
Donna L Havens, LCSW
- Clinical Social Worker
- Bastian, VA
National Provider Identifier
1487768495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904001753
- Practice address
- 12301 Grapefield Rd
Bastian, VA 24314 - Phone
- (276) 688-4331
- Fax
- (276) 688-4336
- NPI assigned
- Aug 18, 2006
- Last updated
- Apr 7, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904001753 | VA | Primary |
Addresses
Primary practice location
12301 Grapefield Rd
Bastian, VA 24314
Mailing address
12301 Grapefield Rd
Bastian, VA 24314
Phone (276) 688-4331
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8957010 | Other | VA | CIGNA |
| 005410916 | Medicaid | VA | |
| 01843900 | Other | VA | MAGELLAN |
| 010383277 | Medicaid | VA | |
| 156228 | Other | VA | VA, DEPT. REHAB. SERVICES |
| 247838 | Other | VA | MTN STATE BC/BC |
| 200101 | Other | VA | MHN |
| 008963312 | Medicaid | VA | |
| 032113 | Other | VA | VALUE OPTIONS |
| 463014 | Other | VA | ALLIANCE/MAPSI |
| 257838 | Other | VA | TRIGON HEALTHKEEPERS |
| 257838 | Other | VI | ANTHEM BC &BS |
| 541999431101 | Other | VA | JOHN DEERE (UBH) |
| 171900 | Other | VA | COMPSYCH |
| 2121987 | Other | VA | MAMSI |
| 257838 | Other | VA | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| T Med Behavioral Inc | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Fairfax, VA
- NPI 1497719272
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586217600000",
"number": "1487768495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12301 GRAPEFIELD RD",
"city": "BASTIAN",
"state": "VA",
"postal_code": "24314",
"telephone_number": "276-688-4331",
"fax_number": "276-688-4336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12301 GRAPEFIELD RD",
"city": "BASTIAN",
"state": "VA",
"postal_code": "24314",
"telephone_number": "276-688-4331",
"fax_number": "276-688-4336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAVENS",
"first_name": "DONNA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2020-04-07",
"certification_date": "2020-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904001753",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "8957010",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005410916",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "01843900",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010383277",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VA, DEPT. REHAB. SERVICES",
"identifier": "156228",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MTN STATE BC/BC",
"identifier": "247838",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "200101",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008963312",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "032113",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALLIANCE/MAPSI",
"identifier": "463014",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIGON HEALTHKEEPERS",
"identifier": "257838",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC &BS",
"identifier": "257838",
"state": "VI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE (UBH)",
"identifier": "541999431101",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPSYCH",
"identifier": "171900",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "2121987",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "257838",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bastian, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.