Individual provider Active NPI

Nancy Ellen Willner, LCSW

  • Clinical Social Worker
  • Charlottesville, VA
National Provider Identifier
1710030648
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904000624 Issued in VA
Practice address
918 Nine and One Half Street N.E.
Charlottesville, VA 22902
Phone
(434) 296-3850
Fax
(434) 296-2928
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0904000624 VA Primary

Addresses

Primary practice location

918 Nine and One Half Street N.E.
Charlottesville, VA 22902

Mailing address

918 9 1/2 St NE
Charlottesville, VA 22902-5311
Phone (434) 296-3850

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
I20050122000013 VA Practitioner - Clinical Social Worker 0941259436 Practice locations: Charlottesville, VA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Virginia Commonwealth University, School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

250 W Main St
Suite 101
Charlottesville, VA 22902-5000
Phone (434) 806-8166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904000624VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catherine M Lawder LCSW PLLC Clinical Past Accepting new patients
Reviving Wellness Counseling Past Accepting new patients

Organizations & group practices 2

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710030648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 9 1/2 ST NE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025311",
            "telephone_number": "434-296-3850",
            "fax_number": "434-296-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 NINE AND ONE HALF STREET N.E.",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22902",
            "telephone_number": "434-296-3850",
            "fax_number": "434-296-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLNER",
        "first_name": "NANCY",
        "middle_name": "ELLEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904000624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.