Individual provider Active NPI

Karen Brodie, LCSW

  • Clinical Social Worker
  • Bassett, VA
National Provider Identifier
1669874772
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904010232 Issued in VA
Practice address
324 T B Stanley Hwy Ste B&C
Bassett, VA 24055-6108
Phone
(276) 629-1076
Fax
(276) 629-2695
NPI assigned
Sep 19, 2014
Last updated
Jan 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10824 SC
Clinical Social Worker 1041C0700X 0904010232 VA Primary

Addresses

Primary practice location

324 T B Stanley Hwy Ste B&C
Bassett, VA 24055-6108

Mailing address

1300 Craven St
Greensboro, NC 27405-4776
Phone (843) 524-8899

Other practice location 1

4944 Greensboro Rd
Ridgeway, VA 24148-3390
Phone (276) 956-2233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10824SCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1669874772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 CRAVEN ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274054776",
            "telephone_number": "843-524-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 T B STANLEY HWY STE B&C",
            "city": "BASSETT",
            "state": "VA",
            "postal_code": "240556108",
            "telephone_number": "276-629-1076",
            "fax_number": "276-629-2695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4944 Greensboro Rd",
            "address_purpose": "LOCATION",
            "city": "Ridgeway",
            "state": "VA",
            "postal_code": "241483390",
            "country_code": "US",
            "telephone_number": "276-956-2233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRODIE",
        "first_name": "KAREN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "10824",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bassett, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.