Active NPI
Kidada Wellington
- Clinical Social Worker
- Chesapeake, VA
National Provider Identifier
1679419840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904019856
- Practice address
- 616 Happy Acres Rd
Chesapeake, VA 23323-2110 - Phone
- (757) 800-3683
- NPI assigned
- Apr 28, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904019856 | VA | Primary |
Addresses
Primary practice location
616 Happy Acres Rd
Chesapeake, VA 23323-2110
Mailing address
815 Liberal Arts CT
Virginia Beach, VA 23462-1081
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904019856 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777334400000",
"number": "1679419840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 LIBERAL ARTS CT",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234621081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "616 HAPPY ACRES RD",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233232110",
"telephone_number": "757-800-3683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLINGTON",
"first_name": "KIDADA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-04-28",
"last_updated": "2026-04-28",
"certification_date": "2026-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904019856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.