Sdhari Antoinette King, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904007721 Issued in VA

Practice address

14 S Holly Ave
Highland Springs, VA 23075-1344

Phone

(804) 652-7283

NPI assigned

Aug 12, 2011

Last updated

Aug 12, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

District 19 Community Services BoardGroup PAC ID 4082502398, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• District 19 Community Services Board

  • Community/Behavioral Health Agency
  • Petersburg, VA
  • NPI 1225094451
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1700165461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 S HOLLY AVE",
            "city": "HIGHLAND SPRINGS",
            "state": "VA",
            "postal_code": "230751344",
            "telephone_number": "804-652-7283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S HOLLY AVE",
            "city": "HIGHLAND SPRINGS",
            "state": "VA",
            "postal_code": "230751344",
            "telephone_number": "804-652-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "SDHARI",
        "middle_name": "ANTOINETTE",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-12",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Linda Ann Johnson, CNA, LPN-A
• Gwendolyn Macon Keeton
• Life Touch Services, LLC
• Life Touch Services, LLC
• Charmaine Malone
• Andrew Gregory Maples II
• Rosita Shirley Mason

• Clinical Social Worker in Highland Springs, VA
• Providers in Highland Springs, 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 Aug 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.