Individual provider Active NPI

Ashlee Collister, MSW, LMHP-S

  • Clinical Social Worker
  • Portsmouth, VA
National Provider Identifier
1770101826
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1805 Airline Blvd
Portsmouth, VA 23707-3912
Phone
(757) 337-3557
NPI assigned
Jul 6, 2020
Last updated
Sep 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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 Primary

Addresses

Primary practice location

1805 Airline Blvd
Portsmouth, VA 23707-3912

Mailing address

1805 Airline Blvd
Portsmouth, VA 23707-3912
Phone (757) 397-2121

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
I20220630001840 VA Practitioner - Clinical Social Worker 5193105641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Child and Family Services of Eastern Virginia, IncGroup PAC ID 7618009333, 4 clinicians

Practice addresses (Care Compare)

222 W 19TH St
Norfolk, VA 23517-2218
Phone (757) 622-7017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Child & Family Services of Eastern Virginia, Inc Clinical CurrentSince Feb 27, 2022 Accepting new patients
Child and Family Services of Eastern Virginia PastSince Jul 12, 2020 Accepting new patients

Locations

222 W 19th St
Norfolk, VA 23517
Phone (757) 622-7017

580 E Main St
Ste 400
Norfolk, VA 23510

1805 Airline Blvd
Portsmouth, VA 23707
Phone (757) 337-3557

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1770101826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 AIRLINE BLVD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073912",
            "telephone_number": "757-397-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 AIRLINE BLVD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073912",
            "telephone_number": "757-337-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLISTER",
        "first_name": "ASHLEE",
        "credential": "MSW, LMHP-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.