Individual provider Active NPI

Beatrice Mills-Desroches, LCSW

  • Clinical Social Worker
  • Hampton, VA
National Provider Identifier
1568524064
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904004572 Issued in VA
Practice address
600 Medical Dr
Suite a
Hampton, VA 23666-1769
Phone
(757) 788-0600
Fax
(757) 788-0932
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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 0904004572 VA Primary

Addresses

Primary practice location

600 Medical Dr
Suite a
Hampton, VA 23666-1769

Mailing address

300 Medical Dr
2ND Floor
Hampton, VA 23666-1765
Phone (757) 788-0092

Other identifiers 1

IdentifierTypeStateIssuer
49-45573MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904004572VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hampton Newport News Community Services Board PastSince Jan 8, 1996 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1568524064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEDICAL DR",
            "address_2": "2ND FLOOR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661765",
            "telephone_number": "757-788-0092",
            "fax_number": "757-788-0969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MEDICAL DR",
            "address_2": "SUITE A",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661769",
            "telephone_number": "757-788-0600",
            "fax_number": "757-788-0932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS-DESROCHES",
        "first_name": "BEATRICE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904004572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49-45573",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.