Individual provider Active NPI

Brittany Botelho, LCSW

  • Clinical Social Worker
  • Hampton, VA
National Provider Identifier
1578255667
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904014266 Issued in VA
Practice address
2 Eaton St Ste 1103
Hampton, VA 23669-4054
Phone
(757) 838-1894
Fax
(757) 838-1895
NPI assigned
May 25, 2023
Last updated
May 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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 0904014266 VA Primary

Addresses

Primary practice location

2 Eaton St Ste 1103
Hampton, VA 23669-4054

Mailing address

2 Eaton St Ste 1103
Hampton, VA 23669-4054
Phone (757) 838-1894

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904014266VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Be Well and Bloom LLC Clinical Current Accepting new patients
Integrated Health Services, LLC CurrentSince May 28, 2023 Accepting new patients

Locations

2 Eaton St
Ste 1103
Hampton, VA 23669
Phone (757) 838-1894

6330 Newtown Rd
Ste 615
Norfolk, VA 23502
Phone (757) 838-1894

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, 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": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1578255667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 EATON ST STE 1103",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236694054",
            "telephone_number": "757-838-1894",
            "fax_number": "757-838-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EATON ST STE 1103",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236694054",
            "telephone_number": "757-838-1894",
            "fax_number": "757-838-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTELHO",
        "first_name": "BRITTANY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904014266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.