Donna L Havens, LCSW

Individual provider Active NPI Clinical Social Worker · Bastian, VA

NPI 1487768495 · NPPES record last updated Apr 7, 2020

Key facts

NPI
1487768495
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
0904001753 (VA)
Practice address
12301 Grapefield Rd
Bastian, VA 24314
Phone
(276) 688-4331
Fax
(276) 688-4336
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
T Med Behavioral Inc Clinical Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904001753 VA Yes

Addresses

Primary practice location

12301 Grapefield Rd
Bastian, VA 24314

Mailing address

12301 Grapefield Rd
Bastian, VA 24314
Phone (276) 688-4331

Other identifiers

IdentifierTypeStateIssuer
032113OtherVAVALUE OPTIONS
247838OtherVAMTN STATE BC/BC
010383277MedicaidVA
2121987OtherVAMAMSI
257838OtherVIANTHEM BC &BS
257838OtherVATRIGON HEALTHKEEPERS
463014OtherVAALLIANCE/MAPSI
005410916MedicaidVA
008963312MedicaidVA
171900OtherVACOMPSYCH
257838OtherVABLUE CROSS BLUE SHIELD
8957010OtherVACIGNA
156228OtherVAVA, DEPT. REHAB. SERVICES
200101OtherVAMHN
01843900OtherVAMAGELLAN
541999431101OtherVAJOHN DEERE (UBH)

Other providers in Bastian, VA

All providers in Bastian, VA · Clinical Social Worker in Virginia

Sources for this page

Verify at the official NPI Registry.