Christen Panissidi, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904011938 Issued in VA

Practice address

11835 Hazel Circle Dr
Bristow, VA 20136-1223

Phone

(757) 705-6823

NPI assigned

Jun 25, 2020

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

Medicare fee-for-service enrollment

Enrolled in DC

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

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 and National Provider Directory roles.

• Safe Harbor Behavioral Care of Northern Virginia LLC

  • Professional Counselor
  • Alexandria, VA
  • NPI 1043660905

  Clinical, DC

  Medicare reassignment NPD
• Safe Harbor Behavioral Care, LLC

  • Clinical Social Worker
  • Bel Air, MD
  • NPI 1316487879
  NPD

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1750907762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 HAZEL CIRCLE DR",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201361223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 HAZEL CIRCLE DR",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201361223",
            "telephone_number": "757-705-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANISSIDI",
        "first_name": "CHRISTEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Novadure Medical Supply LLC
• Stephanie Nyirasafari
• Suhair Obeid Elzubair
• Our Golden Life LLC
• Michael A. Paige, ME.D
• Navnit R Patel
• Patricia Clubb OD PLLC
• Patricia Clubb OD PLLC
• Deandra Lynn Payne-Allen, LPC
• Pediatrics First Speech Therapy

• Clinical Social Worker in Bristow, VA
• Providers in Bristow, 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 Jun 25, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.