Individual provider Active NPI

William R Hale

  • Clinical Social Worker
  • Powhatan, VA
National Provider Identifier
1861262990
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904016128 Issued in VA
Practice address
3910 Old Buckingham Rd
Powhatan, VA 23139-5757
Phone
(804) 598-2200
Fax
(804) 598-3114
NPI assigned
Jan 9, 2024
Last updated
Jan 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 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 0904016128 VA Primary

Addresses

Primary practice location

3910 Old Buckingham Rd
Powhatan, VA 23139-5757

Mailing address

PO Box 189
Goochland, VA 23063-0189
Phone (804) 556-5400

Other practice location 1

3058 River Rd W
Goochland, VA 23063-3202
Phone (804) 556-5400

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
I20240131000817 VA Practitioner - Clinical Social Worker 8921451527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goochland Powhatan Community ServicesGroup PAC ID 5193812501, 10 clinicians

Practice addresses (Care Compare)

3910 Old Buckingham Rd
Powhatan, VA 23139-5757
Phone (804) 598-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904016128VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Goochland Powhatan Community Services CurrentSince Dec 24, 2023 Accepting new patients
Goochland County Board of Supervisors PastSince Dec 24, 2023 Accepting new patients

Locations

3910 Old Buckingham Rd
Powhatan, VA 23139
Phone (804) 598-2200

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, 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": "1704758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1861262990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "GOOCHLAND",
            "state": "VA",
            "postal_code": "230630189",
            "telephone_number": "804-556-5400",
            "fax_number": "804-556-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 OLD BUCKINGHAM RD",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231395757",
            "telephone_number": "804-598-2200",
            "fax_number": "804-598-3114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3058 River Rd W",
            "address_purpose": "LOCATION",
            "city": "Goochland",
            "state": "VA",
            "postal_code": "230633202",
            "country_code": "US",
            "telephone_number": "804-556-5400",
            "fax_number": "804-556-5403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALE",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904016128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powhatan, VA

Sources for this page

Verify at the official NPI Registry.