Organization Active NPI

Dr. James W. Eisenhower, PH.D, LCSW, LLC

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1720293772
Registry record updated Aug 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904000683 Issued in VA
Legal business name
DR. JAMES W. EISENHOWER, PH.D, LCSW, LLC
Practice address
281 Independence Blvd
#305
Virginia Beach, VA 23462-2986
Phone
(757) 373-6051
Fax
(757) 497-1327
NPI assigned
May 12, 2007
Last updated
Aug 3, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2007

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

Authorized official

Name
Dr. James W. Eisenhower, PH.D.NPI 1952407900
Title
LCSW
Phone
(757) 373-6051

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904000683 VA Primary

Addresses

Primary practice location

281 Independence Blvd
#305
Virginia Beach, VA 23462-2986

Mailing address

281 Independence Blvd
#305
Virginia Beach, VA 23462-2986
Phone (757) 373-6051

Other identifiers 1

IdentifierTypeStateIssuer
1952407900MedicaidVA

National Provider Directory

National Provider Directory

Locations

732 Thimble Shoals Blvd
Ste 902
Newport News, VA 23606
Phone (757) 373-6051

281 Independence Blvd
Ste 305
Virginia Beach, VA 23462
Phone (757) 373-6051

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186099200000",
    "number": "1720293772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 INDEPENDENCE BLVD",
            "address_2": "#305",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234622986",
            "telephone_number": "757-373-6051",
            "fax_number": "757-497-1327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 INDEPENDENCE BLVD",
            "address_2": "#305",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234622986",
            "telephone_number": "757-373-6051",
            "fax_number": "757-497-1327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JAMES W. EISENHOWER, PH.D, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-12",
        "last_updated": "2007-08-03",
        "status": "A",
        "authorized_official_last_name": "EISENHOWER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "757-373-6051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904000683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952407900",
            "state": "VA"
        }
    ],
    "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 Aug 3, 2007; 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.