Individual provider Active NPI

Whitney Jackson McLellon, LCSW

  • Clinical Social Worker
  • Williamsburg, VA
National Provider Identifier
1780439059
Registry record updated Apr 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904016718 Issued in VA
Practice address
1101 Professional Dr Ste B
Williamsburg, VA 23185-3301
Phone
(757) 969-8639
NPI assigned
Apr 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2024

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 0904016718 VA Primary

Addresses

Primary practice location

1101 Professional Dr Ste B
Williamsburg, VA 23185-3301

Mailing address

133 Bennett Rd
Poquoson, VA 23662-1703
Phone (757) 342-6068

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
I20240716000440 VA Practitioner - Clinical Social Worker 2163967027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Invicta Wellness CenterGroup PAC ID 2365829538, 4 clinicians

Practice addresses (Care Compare)

1101 Professional Dr
Suite B
Williamsburg, VA 23185-3301
Phone (757) 969-8639

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Invicta Wellness Center Clinical CurrentSince Jun 1, 2024 Accepting new patients
Grace D. Shortt, LCSW Acsw LLC Clinical PastSince Apr 21, 2024 Accepting new patients

Locations

1101 Professional Dr
Ste B
Williamsburg, VA 23185
Phone (757) 338-6492

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1713571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713571200000",
    "number": "1780439059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BENNETT RD",
            "city": "POQUOSON",
            "state": "VA",
            "postal_code": "236621703",
            "telephone_number": "757-342-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 PROFESSIONAL DR STE B",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231853301",
            "telephone_number": "757-969-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLELLON",
        "first_name": "WHITNEY",
        "middle_name": "JACKSON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-20",
        "last_updated": "2024-04-20",
        "certification_date": "2024-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904016718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.