Individual provider Active NPI

Cynthia Withrow, LCSW

  • Clinical Social Worker
  • Roanoke, VA
National Provider Identifier
1689995177
Registry record updated Jun 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904007391 Issued in VA
Practice address
3517 Brandon Ave SW
Roanoke, VA 24018-1523
Phone
(540) 981-1102
Fax
(540) 344-4169
NPI assigned
Jun 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2010

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 0904007391 VA Primary

Addresses

Primary practice location

3517 Brandon Ave SW
Roanoke, VA 24018-1523

Mailing address

301 Elm Ave SW
Roanoke, VA 24016-4001

Other identifiers 1

IdentifierTypeStateIssuer
1437137734MedicaidVA

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
I20160921000706 VA Practitioner - Clinical Social Worker 7012204944 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904007391VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Behavioral Healthcare CurrentSince Jun 25, 2016 Accepting new patients

Locations

301 Elm Ave SW
Roanoke, VA 24016
Phone (540) 266-9200

611 McDowell Ave NW
Roanoke, VA 24016
Phone (540) 266-9200

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": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276819200000",
    "number": "1689995177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ELM AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3517 BRANDON AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181523",
            "telephone_number": "540-981-1102",
            "fax_number": "540-344-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHROW",
        "first_name": "CYNTHIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2010-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437137734",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.