Christine Komiske Dwyer, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904008296 Issued in VA

Practice address

4581 Lifestyle LN
Suite 206
Midlothian, VA 23112-4807

Phone

(804) 608-9430

NPI assigned

Nov 14, 2013

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

• Lori Christine Komiske Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 13, 2016.

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1649600404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4581 LIFESTYLE LN",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124807",
            "telephone_number": "804-608-9430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4581 LIFESTYLE LN",
            "address_2": "SUITE 206",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124807",
            "telephone_number": "804-608-9430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWYER",
        "first_name": "CHRISTINE",
        "middle_name": "KOMISKE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-14",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "KOMISKE",
            "middle_name": "CHRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Midlothian, VA
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; 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.