Melissa South, L.C.S.W.
Individual provider Active NPI Clinical Social Worker · Saluda, VA
NPI 1821499609 · NPPES record last updated Sep 11, 2014
Key facts
- NPI
- 1821499609
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 0904008712 (VA)
- Practice address
- 129 Bowden St
Saluda, VA 23149 - Phone
- (804) 758-4035
- Fax
- (804) 695-8122
- NPI assigned
- Sep 11, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 22
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Virginia Commonwealth University, School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Central Virginia Health Services Inc
Practice addresses (Care Compare)
11814 King William Rd
Aylett, VA 23009-4103
Phone (804) 769-3022
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150318001507 | VA | Practitioner - Clinical Social Worker | 2163749839 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Middle Peninsula-Northern Neck Mental Health and Mental Retardation | Current |
Accepting new patients | |
| Central Virginia Health Services Inc | Current |
Accepting new patients | |
| Middle Peninsula Northern Neck Mental Health & Retardation | Current |
Accepting new patients | |
| Central Virginia Health Services Inc | Current |
Accepting new patients | |
| Central Virginia Health Services Inc | Current | Accepting new patients | |
| Central Virginia Health Services Inc | Current |
Accepting new patients | |
| Middle Peninsula Northern Neck Community Services Board | Past | Accepting new patients |
Locations
11814 King William Rd
Aylett, VA 23009
Phone (804) 769-3002
1101 E Jefferson St
Charlottesvle, VA 22902
Phone (434) 227-5624
1041 Sharon Rd
Ste 201
King William, VA 23086
Phone (804) 769-2751
25892 N James Madison Hwy
New Canton, VA 23123
Phone (434) 581-3271
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904008712 | VA | Yes |
Addresses
Primary practice location
129 Bowden St
Saluda, VA 23149
Mailing address
PO Box 40
Saluda, VA 23149-0040
Phone (804) 758-4035
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497717615 | Medicaid | VA |
NPI Registry JSON
{
"created_epoch": "1410393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410393600000",
"number": "1821499609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 40",
"city": "SALUDA",
"state": "VA",
"postal_code": "231490040",
"telephone_number": "804-758-4035",
"fax_number": "804-695-8122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 BOWDEN ST",
"city": "SALUDA",
"state": "VA",
"postal_code": "23149",
"telephone_number": "804-758-4035",
"fax_number": "804-695-8122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTH",
"first_name": "MELISSA",
"credential": "L.C.S.W.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-11",
"last_updated": "2014-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904008712",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1497717615",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saluda, VA
- Darryl John Pirok
- Precision Health Management Inc
- Katrina Rhodes
- Riverside Physician Services Inc
- Kathleen Sauter
- Shannon Lee Stone
- Three Rivers Health District
- William Theodore Tweel Jr.
- United States Coast Guard
All providers in Saluda, VA · Clinical Social Worker in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.