NPIMap

Individual provider Active NPI

Deborah K Wrinkle, L.C.S.W

  • Clinical Social Worker
  • Gloucester, VA
National Provider Identifier
1770819484
Registry record updated Oct 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904007233 Issued in VA
Practice address
9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162
Phone
(804) 695-8119
Fax
(804) 695-8122
NPI assigned
Oct 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2009

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 0904007233 VA Primary

Addresses

Primary practice location

9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162

Mailing address

9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162
Phone (804) 695-8119

Other identifiers 3

IdentifierTypeStateIssuer
1497717615MedicaidVA
294721OtherVAVALUE OPTIONS
1497717615OtherVAVA PREMIER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904007233VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Peninsula-Northern Neck Mental Health and Mental Retardation Past Accepting new patients
Colonial Behavioral Health Past Accepting new patients
Chesapeake Counseling Associates PC Past Accepting new patients
Middle Peninsula Northern Neck Mental Health & Retardation PastSince Jul 1, 2013 Accepting new patients

Organizations & group practices 4

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": "1256860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256860800000",
    "number": "1770819484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9228 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614162",
            "telephone_number": "804-695-8119",
            "fax_number": "804-695-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614162",
            "telephone_number": "804-695-8119",
            "fax_number": "804-695-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRINKLE",
        "first_name": "DEBORAH",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-30",
        "last_updated": "2009-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497717615",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "294721",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA PREMIER",
            "identifier": "1497717615",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; 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.