Individual provider Active NPI

Amber Eason, LCSW

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1700154523
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904011246 Issued in VA
Practice address
505 S Independence Blvd Ste 213
Virginia Beach, VA 23452-1150
Phone
(757) 376-8167
NPI assigned
Dec 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 0904011246 VA Primary

Addresses

Primary practice location

505 S Independence Blvd Ste 213
Virginia Beach, VA 23452-1150

Mailing address

505 S Independence Blvd Ste 213
Virginia Beach, VA 23452-1150
Phone (757) 376-8167

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
0904011246VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine & Glory Counseling PLLC PastSince Dec 10, 2021 Accepting new patients

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": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1700154523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S INDEPENDENCE BLVD STE 213",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521150",
            "telephone_number": "757-376-8167",
            "fax_number": "757-452-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S INDEPENDENCE BLVD STE 213",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521150",
            "telephone_number": "757-376-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASON",
        "first_name": "AMBER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.