Individual provider Active NPI

Kristina B Alley, LCSW

  • Clinical Social Worker
  • Richmond, VA
National Provider Identifier
1497044143
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904007612 Issued in VA
Practice address
107 S 5TH St
Richmond, VA 23219-3825
Phone
(804) 819-4000
Fax
(804) 819-5221
NPI assigned
Apr 4, 2011
Last updated
Oct 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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 0904007612 VA Primary

Addresses

Primary practice location

107 S 5TH St
Richmond, VA 23219-3825

Mailing address

107 S 5TH St
Richmond, VA 23219-3825
Phone (804) 819-4000

Other identifiers 1

IdentifierTypeStateIssuer
4945255MedicaidVA

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
I20110707000107 VA Practitioner - Clinical Social Worker 5799963138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Care LLCGroup PAC ID 0042458200, 42 clinicians

Practice addresses (Care Compare)

2901 S Lynnhaven Rd
Suite 450
Virginia Beach, VA 23452-8524

780 Lynnhaven Pkwy
Suite 400
Virginia Beach, VA 23452-7332
Phone (757) 536-2246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904007612VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Care LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

2901 S Lynnhaven Rd
Ste 450
Virginia Beach, VA 23452
Phone (757) 351-4585

780 Lynnhaven Pkwy
Ste 400
Virginia Beach, VA 23452
Phone (201) 581-3411

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.

NPI Registry JSON

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477008000000",
    "number": "1497044143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S 5TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232193825",
            "telephone_number": "804-819-4000",
            "fax_number": "804-819-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S 5TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232193825",
            "telephone_number": "804-819-4000",
            "fax_number": "804-819-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEY",
        "first_name": "KRISTINA",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2016-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4945255",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.