Individual provider Active NPI

Shari Lynnette Williams, LCSW

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1598307639
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904011274 Issued in VA
Practice address
3143 Magic Hollow Blvd Ste 200
Virginia Beach, VA 23453-3077
Phone
(757) 385-4271
NPI assigned
Oct 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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 0904011274 VA Primary

Addresses

Primary practice location

3143 Magic Hollow Blvd Ste 200
Virginia Beach, VA 23453-3077

Mailing address

1322 Sagamore CT
Virginia Beach, VA 23464-8675
Phone (757) 450-5022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210413001550 TX Practitioner - Clinical Social Worker 5395171789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Psychological Care Sa I LLCGroup PAC ID 5193999860, 13 clinicians

Practice addresses (Care Compare)

3838 E Southcross Blvd
SCC Pecan Valley Rehabilitation and Healthcar
San Antonio, TX 78222-3556
Phone (210) 581-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103778TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Psychological Care Sa I, LLC Clinical CurrentSince Mar 31, 2021 Accepting new patients

Locations

11127 Circle Dr
Austin, TX 78736
Phone (512) 288-8844

4635 Southwest Fwy
Ste 635
Houston, TX 77027
Phone (214) 923-7777

5027 Pecan Grove Blvd
San Antonio, TX 78222
Phone (210) 333-6815

3838 E Southcross Blvd
San Antonio, TX 78222
Phone (210) 581-2273

2003 W Hutchins Pl
San Antonio, TX 78224
Phone (210) 927-0800

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": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1598307639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 SAGAMORE CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234648675",
            "telephone_number": "757-450-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3143 MAGIC HOLLOW BLVD STE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234533077",
            "telephone_number": "757-385-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHARI",
        "middle_name": "LYNNETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.