Marie Immacula Hyppolite, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904007767 Issued in VA

Practice address

546 Walnut Grove Dr
Jarratt, VA 23867-8611

Phone

(434) 634-3217

Fax

(434) 348-3471

NPI assigned

Nov 10, 2011

Last updated

Nov 10, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1508143132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 FAYE ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232256202",
            "telephone_number": "434-634-3217",
            "fax_number": "434-348-3471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 WALNUT GROVE DR",
            "city": "JARRATT",
            "state": "VA",
            "postal_code": "238678611",
            "telephone_number": "434-634-3217",
            "fax_number": "434-348-3471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYPPOLITE",
        "first_name": "MARIE",
        "middle_name": "IMMACULA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-10",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0904007767",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Jarratt, VA
• Providers in Jarratt, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.