Chrisonia Reneice Broadnax, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904015868 Issued in VA

Practice address

205 Lookout Way
Fredericksburg, VA 22405-1244

Phone

(270) 303-9247

NPI assigned

Aug 19, 2011

Last updated

Oct 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Ms. Chrisonia Reneice Thomas Former name

Medicare fee-for-service enrollment

Enrolled in IN, VA, DC, MN4 enrollments

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 4

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/lhsoutheast/r4/

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.

• Nephrology Associates of Northern Virginia, Inc

  • Nephrology Physician
  • Fairfax, VA
  • NPI 1174541049

  DC

  Medicare reassignment NPD
• Evergreen Nephrology PLLC

  • Nephrology Physician
  • Nashville, TN
  • NPI 1982305082

  Social Worker, VA

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, IN, MN

  Medicare reassignment NPD
• Living Hope Southeast, LLC

  • Mental Health Counselor
  • Monticello, AR
  • NPI 1689877862
  NPD (past)

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1770863979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 LOOKOUT WAY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224051244",
            "telephone_number": "270-303-9247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 LOOKOUT WAY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224051244",
            "telephone_number": "270-303-9247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADNAX",
        "first_name": "CHRISONIA",
        "middle_name": "RENEICE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34010681A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904015868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISONIA",
            "last_name": "THOMAS",
            "middle_name": "RENEICE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yuri Anne L Brinkman, RN
• Marietta Briones, PT
• Meggen M Briscoe, D.C.
• Laura Britton, PA-C
• Mary Grace Britton, RBT
• Jay David Brock, M.D.
• Lee R Brock, MD
• Piper L Brock, DO
• Robert Irving Broder, M.D.
• Alfred J Bromm Jr., PHARMD

• Clinical Social Worker in Fredericksburg, VA
• Providers in Fredericksburg, 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 Oct 3, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.