NPIMap

Organization Active NPI

Danville Pittsylvania Community Services

  • Clinical Social Worker
  • Danville, VA
National Provider Identifier
1669410064
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904005264 Issued in VA
Legal business name
DANVILLE PITTSYLVANIA COMMUNITY SERVICES
Practice address
425 Hairston St
Danville, VA 24540-4133
Phone
(434) 793-4931
Fax
(434) 799-3100
NPI assigned
Jun 4, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. James F Bebeau, LPC
Title
Director of Mental Health
Phone
(434) 793-4931

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

National Provider Directory
Tax ID family
Danville Pittsylvania C (5 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 0904005264 VA Primary

Addresses

NPPES NPI Registry

Primary practice location

425 Hairston St
Danville, VA 24540-4133

Mailing address

425 Hairston St
Danville, VA 24540-4133
Phone (434) 793-4931

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
P00195293OtherVARAILROAD MEDICARE
010135419MedicaidVA
175108OtherVABLUE CROSS BLUE SHIELD VA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669410064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 HAIRSTON ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245404133",
            "telephone_number": "434-793-4931",
            "fax_number": "434-799-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 HAIRSTON ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245404133",
            "telephone_number": "434-793-4931",
            "fax_number": "434-799-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANVILLE PITTSYLVANIA COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEBEAU",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DIRECTOR OF MENTAL HEALTH",
        "authorized_official_telephone_number": "434-793-4931",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00195293",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010135419",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD VA",
            "identifier": "175108",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.