Individual provider Active NPI

Cecil Lynn Garrison Jr., LCSW, LSATP

  • Clinical Social Worker
  • Chantilly, VA
National Provider Identifier
1548372915
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904004919 Issued in VA
Practice address
4213 Walney Rd
Chantilly, VA 20151-2923
Phone
(703) 502-7017
Fax
(703) 502-7055
NPI assigned
Aug 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0904004919 VA Primary

Addresses

Primary practice location

4213 Walney Rd
Chantilly, VA 20151-2923

Mailing address

14818 Wood Home Rd
Centreville, VA 20120-1546
Phone (703) 266-7097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20221220002322 NC Practitioner - Clinical Social Worker 6305215096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Virginia Commonwealth University, School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (984) 974-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904004919VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina Hospitals at Chapel Hill CurrentSince Sep 30, 2022 Accepting new patients
University of North Carolina Hospitals at Chapel Hill CurrentSince Sep 30, 2022 Accepting new patients
University of North Carolina Hospitals at Chapel Hill Past Accepting new patients

Locations

100 Sprunt St
Chapel Hill, NC 27517
Phone (919) 843-2164

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

1101 Weaver Dairy Rd
Ste 103
Chapel Hill, NC 27514
Phone (919) 966-6039

5221 Paramount Pkwy
Ste 440
Morrisville, NC 27560
Phone (984) 974-1183

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548372915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14818 WOOD HOME RD",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201201546",
            "telephone_number": "703-266-7097",
            "fax_number": "703-502-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 WALNEY RD",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201512923",
            "telephone_number": "703-502-7017",
            "fax_number": "703-502-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRISON",
        "first_name": "CECIL",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW, LSATP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904004919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

Verify at the official NPI Registry.