Individual provider Active NPI

Judy Ann Free, LCSW

  • Clinical Social Worker
  • Pennington Gap, VA
National Provider Identifier
1861716375
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904004980 Issued in VA
Practice address
244 Burke St
Pennington Gap, VA 24277-1366
Phone
(423) 361-2516
NPI assigned
Mar 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904004980 VA Primary
Clinical Social Worker 1041C0700X LSW0000004291 TN

Addresses

Primary practice location

244 Burke St
Pennington Gap, VA 24277-1366

Mailing address

244 Burke St
Pennington Gap, VA 24277-1366
Phone (423) 361-2516

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
LSW0000004291TNMDClinical Social Worker
0904004980VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Resources, Inc Past Accepting new patients
Regional Health Resources Inc Past Accepting new patients

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": "1269561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1861716375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 BURKE ST",
            "city": "PENNINGTON GAP",
            "state": "VA",
            "postal_code": "242771366",
            "telephone_number": "423-361-2516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 BURKE ST",
            "city": "PENNINGTON GAP",
            "state": "VA",
            "postal_code": "242771366",
            "telephone_number": "423-361-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREE",
        "first_name": "JUDY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-26",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904004980",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000004291",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennington Gap, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; 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.