Individual provider Active NPI

Andre Allen, LCSW, MSW

  • Clinical Social Worker
  • Chesapeake, VA
National Provider Identifier
1629805304
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904017234 Issued in VA
Practice address
816 Greenbrier Cir Ste 100
Chesapeake, VA 23320-2645
Phone
(804) 207-6737
Fax
(757) 301-8803
NPI assigned
Sep 17, 2024
Last updated
May 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2026

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 0904017234 VA Primary

Addresses

Primary practice location

816 Greenbrier Cir Ste 100
Chesapeake, VA 23320-2645

Mailing address

816 Greenbrier Cir Ste 100
Chesapeake, VA 23320-2645
Phone (804) 207-6737

Other practice location 1

1500 Shipyard Rd Ste D1128
Chesapeake, VA 23323-5516
Phone (302) 827-3481

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
I20241216001124 VA Practitioner - Clinical Social Worker 6204362130 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904017234VAMDClinical Social Worker

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": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1629805304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 GREENBRIER CIR STE 100",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202645",
            "telephone_number": "804-207-6737",
            "fax_number": "757-301-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 GREENBRIER CIR STE 100",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202645",
            "telephone_number": "804-207-6737",
            "fax_number": "757-301-8803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Shipyard Rd Ste D1128",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233235516",
            "country_code": "US",
            "telephone_number": "302-827-3481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "ANDRE",
        "credential": "LCSW, MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-17",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904017234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.