Individual provider Active NPI

Chelsy Pelletier-Blain, LCSW

  • Clinical Social Worker
  • Fort Belvoir, VA
National Provider Identifier
1811144579
Registry record updated May 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904011410 Issued in VA
Practice address
9300 Dewitt Loop
Fort Belvoir, VA 22060-5285
Phone
(571) 231-3224
NPI assigned
Aug 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 115901 MA
Clinical Social Worker 1041C0700X 0904011410 VA Primary

Addresses

Primary practice location

9300 Dewitt Loop
Fort Belvoir, VA 22060-5285

Mailing address

9300 Dewitt Loop
Fort Belvoir, VA 22060-5285
Phone (571) 231-3224

Other identifiers 1

IdentifierTypeStateIssuer
1811144579OtherMANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
115901MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588982400000",
    "number": "1811144579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER-BLAIN",
        "first_name": "CHELSY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2020-05-09",
        "certification_date": "2020-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115901",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1811144579",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Belvoir, VA

Sources for this page

Verify at the official NPI Registry.