Christine D Bradshaw Earl, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904002173 Issued in VA

Practice address

224 Great Bridge Blvd
City of Chesapeake Ta Ches Comm Service Board
Chesapeake, VA 23320-3904

Phone

(757) 547-9334

Fax

(757) 819-6292

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Independence Therapy Center P C

  • Counselor
  • Virginia Beach, VA
  • NPI 1497853527
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261958400000",
    "number": "1699848960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 GREAT BRIDGE BLVD",
            "address_2": "CITY OF CHESAPEAKE TA CHES COMM SERVICE BOARD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "23320",
            "telephone_number": "757-547-9334",
            "fax_number": "757-819-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 GREAT BRIDGE BLVD",
            "address_2": "CITY OF CHESAPEAKE TA CHES COMM SERVICE BOARD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203904",
            "telephone_number": "757-547-9334",
            "fax_number": "757-819-6292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW EARL",
        "first_name": "CHRISTINE",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2009-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904002173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "324054",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "033147",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM TRIGON",
            "identifier": "176185",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "920225",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Lynn Bozard, MSN,APRN,PMHNP-BC
• Ramona Brabson, LCSW
• Kari Braca, M.A., CCC-SLP
• Brad Christenson DDS PC
• Corey L Bradley, PHARMD
• Donna Marie Bradshaw, AGNP
• Heather Brady, RESIDENT IN MARRIAGE
• Kimala Brady
• Kasten Elizabeth Brafford
• Braley & Thompson, Inc.

• Clinical Social Worker in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; 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.