Individual provider Active NPI

Soroush Hemmati, LCSW

  • Clinical Social Worker
  • Richmond, VA
National Provider Identifier
1811715949
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904017038 Issued in VA
Practice address
5540 Cardiff CT Apt D
Richmond, VA 23227-3164
Phone
(703) 678-8735
NPI assigned
Sep 27, 2024
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 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 0904017038 VA Primary

Addresses

Primary practice location

5540 Cardiff CT Apt D
Richmond, VA 23227-3164

Mailing address

5540 Cardiff CT Apt D
Richmond, VA 23227-3164

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
I20250327001472 VA Practitioner - Clinical Social Worker 9830612134 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904017038VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prince William County Community Services Board CurrentSince Mar 31, 2025 Accepting new patients
Prince William County CurrentSince Mar 31, 2025 Accepting new patients
Givpour Clinical Past Accepting new patients

Locations

7969 Ashton Ave
Manassas, VA 20109
Phone (703) 792-7826

14011 Worth Ave
Ste 110
Woodbridge, VA 22192

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1811715949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5540 CARDIFF CT APT D",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232273164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5540 CARDIFF CT APT D",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232273164",
            "telephone_number": "703-678-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMMATI",
        "first_name": "SOROUSH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904017038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.