Individual provider Active NPI

Shalanda Weems, LCSW

  • Clinical Social Worker
  • Woodbridge, VA
National Provider Identifier
1669624243
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904006949 Issued in VA
Practice address
3146 Golansky Blvd Ste 101
Woodbridge, VA 22192-4261
Phone
(703) 530-8055
NPI assigned
Oct 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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 0904006949 VA Primary

Addresses

Primary practice location

3146 Golansky Blvd Ste 101
Woodbridge, VA 22192-4261

Mailing address

3146 Golansky Blvd Ste 101
Woodbridge, VA 22192-4261
Phone (703) 530-8055

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
I20090515000116 VA Practitioner - Clinical Social Worker 7719036094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3146 Golansky Blvd
Suite 101
Woodbridge, VA 22192-4261
Phone (703) 530-8055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904006949VAMDClinical Social Worker

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1669624243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3146 GOLANSKY BLVD STE 101",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924261",
            "telephone_number": "703-530-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3146 GOLANSKY BLVD STE 101",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924261",
            "telephone_number": "703-530-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEEMS",
        "first_name": "SHALANDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.