Individual provider Active NPI

Felicia B Lane, LCSW

  • Clinical Social Worker
  • Roanoke, VA
National Provider Identifier
1639686413
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904010211 Issued in VA
Practice address
4419 Pheasant Ridge Rd Ste 200
Roanoke, VA 24014-5267
Phone
(540) 315-5318
Fax
(540) 566-3320
NPI assigned
Jan 3, 2018
Last updated
Sep 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 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 0904010211 VA Primary

Addresses

Primary practice location

4419 Pheasant Ridge Rd Ste 200
Roanoke, VA 24014-5267

Mailing address

4419 Pheasant Ridge Rd Ste 200
Roanoke, VA 24014-5267
Phone (540) 315-5318

Other identifiers 1

IdentifierTypeStateIssuer
0004945221MedicaidVA

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
I20180321000543 VA Practitioner - Clinical Social Worker 5294097762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4419 Pheasant Ridge Rd
Suite 200
Roanoke, VA 24014-5267
Phone (540) 315-5318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904010211VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Empowered Well-Being Counseling, LLC Clinical CurrentSince May 5, 2019 Accepting new patients

Locations

4220 Cypress Park Dr
Ste B
Roanoke, VA 24018
Phone (540) 772-1872

4419 Pheasant Ridge Rd
Ste 200
Roanoke, VA 24014
Phone (540) 315-5318

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, 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": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1639686413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 PHEASANT RIDGE RD STE 200",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240145267",
            "telephone_number": "540-315-5318",
            "fax_number": "540-566-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 PHEASANT RIDGE RD STE 200",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240145267",
            "telephone_number": "540-315-5318",
            "fax_number": "540-566-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "FELICIA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0004945221",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.