Individual provider Active NPI

Varney Goll, LCSW

  • Clinical Social Worker
  • Norfolk, VA
National Provider Identifier
1568094233
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904011383 Issued in VA
Practice address
850 Tidewater Dr Ste a
Norfolk, VA 23504-3300
Phone
(757) 315-8039
NPI assigned
Feb 10, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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 0904011383 VA Primary

Addresses

Primary practice location

850 Tidewater Dr Ste a
Norfolk, VA 23504-3300

Mailing address

850 Tidewater Dr Ste a
Norfolk, VA 23504-3300

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
I20231107002586 VA Practitioner - Clinical Social Worker 4789031121 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904011383VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
GHR Center for Opioid Addiction Treatment and Recovery LLC CurrentSince Aug 8, 2023 Accepting new patients
Afi Outpatient Mental Health Services, Inc. Clinical PastSince Jul 15, 2021 Accepting new patients

Locations

850 Tidewater Dr
#A
Norfolk, VA 23504
Phone (757) 333-6992

Organizations & group practices 2

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": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1568094233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 TIDEWATER DR STE A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235043300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 TIDEWATER DR STE A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235043300",
            "telephone_number": "757-315-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLL",
        "first_name": "VARNEY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-10",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.