Individual provider Active NPI

Aaliyah Haise, MSW,LPN

  • Case Management Agency
  • Fredericksburg, VA
National Provider Identifier
1821493586
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
S4493401 Issued in VA
Practice address
102 Excaliber Cir
104
Fredericksburg, VA 22406-6482
Phone
(540) 661-9007
Fax
(703) 890-2969
NPI assigned
Oct 23, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X S4493401 VA Primary

Addresses

Primary practice location

102 Excaliber Cir
104
Fredericksburg, VA 22406-6482

Mailing address

102 Excaliber Cir
104
Fredericksburg, VA 22406-6482
Phone (540) 661-9007

Other identifiers 1

IdentifierTypeStateIssuer
0172986405MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S4493401VAMDCase Management Agency

NPI Registry JSON

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1821493586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 EXCALIBER CIR",
            "address_2": "104",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224066482",
            "telephone_number": "540-661-9007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 EXCALIBER CIR",
            "address_2": "104",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224066482",
            "telephone_number": "540-661-9007",
            "fax_number": "703-890-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAISE",
        "first_name": "AALIYAH",
        "credential": "MSW,LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "VA",
            "license": "S4493401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0172986405",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.