Individual provider Active NPI

Myecha Kitchen, LCSW

  • Clinical Social Worker
  • Suffolk, VA
National Provider Identifier
1831080282
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904018102 Issued in VA
Practice address
200 W Constance Rd
Suffolk, VA 23434-4413
Phone
(757) 539-8744
NPI assigned
Jul 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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 0904018102 VA Primary

Addresses

Primary practice location

200 W Constance Rd
Suffolk, VA 23434-4413

Mailing address

1364 29TH St
Newport News, VA 23607-3704
Phone (757) 254-6934

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
I20260224004145 VA Practitioner - Clinical Social Worker 6800377243 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SE Virginia Value Based Care LLCGroup PAC ID 6103288170, 160 clinicians
Mid Atlantic Long Term Specialty Care LLCGroup PAC ID 8921427162, 28 clinicians

Practice addresses (Care Compare)

Norfolk, VA 23502
Phone (757) 354-2885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904018102VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Atlantic Long Term Specialty Care LLC CurrentSince Jan 20, 2026 Accepting new patients
SE Virginia Value Based Care, LLC CurrentSince Jan 10, 2026 Accepting new patients

Locations

6160 Kempsville Cir
Ste 325A
Norfolk, VA 23502
Phone (757) 354-2885

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1831080282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1364 29TH ST",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236073704",
            "telephone_number": "757-254-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W CONSTANCE RD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344413",
            "telephone_number": "757-539-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITCHEN",
        "first_name": "MYECHA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904018102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.