Individual provider Active NPI

Brian Eugene Preston, LCSW

  • Clinical Social Worker
  • Suffolk, VA
National Provider Identifier
1801395124
Registry record updated Feb 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904010343 Issued in VA
Practice address
7025 Harbour View Blvd Ste 119
Suffolk, VA 23435-2762
Phone
(757) 966-2805
Fax
(757) 673-2586
NPI assigned
Feb 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2018

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 0904010343 VA Primary

Addresses

Primary practice location

7025 Harbour View Blvd Ste 119
Suffolk, VA 23435-2762

Mailing address

7025 Harbour View Blvd Ste 119
Suffolk, VA 23435-2762
Phone (757) 966-2805

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
I20200910002387 VA Practitioner - Clinical Social Worker 7214290642 Practice locations: Virginia Beach, VA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904010343VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517529600000",
    "number": "1801395124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7025 HARBOUR VIEW BLVD STE 119",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352762",
            "telephone_number": "757-966-2805",
            "fax_number": "757-673-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7025 HARBOUR VIEW BLVD STE 119",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352762",
            "telephone_number": "757-966-2805",
            "fax_number": "757-673-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "BRIAN",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-02",
        "last_updated": "2018-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.