Individual provider Active NPI

Antoinette Louise Peace, LCSW

  • Clinical Social Worker
  • Richmond, VA
National Provider Identifier
1558948042
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008744 Issued in VA
Practice address
107 S 5TH St
Richmond, VA 23219-3825
Phone
(804) 819-4000
Fax
(804) 819-5221
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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 0904008744 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

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
I20210603002090 VA Practitioner - Clinical Social Worker 4789083270 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904008744VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse Behavioral Health Center, LLC Clinical CurrentSince May 17, 2021 Accepting new patients
Richmond Creative Counseling, LLC Past Accepting new patients
Richmond Creative Counseling Clinical Past Accepting new patients

Locations

8310 Midlothian Tpke
North Chesterfield, VA 23235
Phone (804) 447-6382

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1558948042",
    "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": "PEACE",
        "first_name": "ANTOINETTE",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.