Individual provider Active NPI

Shaleta Epps

  • Clinical Social Worker
  • Richmond, VA
National Provider Identifier
1629446455
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008877 Issued in VA
Practice address
1500 Brook Rd
Richmond, VA 23220-2308
Phone
(804) 225-9144
Fax
(804) 225-9145
NPI assigned
Sep 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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 0904008877 VA Primary

Addresses

Primary practice location

1500 Brook Rd
Richmond, VA 23220-2308

Mailing address

12501 Branner Way Apt 103
Chester, VA 23836-2806
Phone (804) 721-9715

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinical & Consulting Services, LLC Current Accepting new patients
Mindful Solutions Clinical & Consulting Services, LLC Clinical Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: shaleta.epps.p1@direct.d19csb.nextgenshare.com

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": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1629446455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 BRANNER WAY APT 103",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238362806",
            "telephone_number": "804-721-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 BROOK RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232202308",
            "telephone_number": "804-225-9144",
            "fax_number": "804-225-9145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPS",
        "first_name": "SHALETA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.