NPIMap

Organization Active NPI

Spiritually Inspired Transformation Services

  • Clinical Social Worker
  • Yorktown, VA
National Provider Identifier
1861980260
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904009647 Issued in VA
Legal business name
SPIRITUALLY INSPIRED TRANSFORMATION SERVICES
Practice address
104 Wexford CT
Yorktown, VA 23693-4597
Phone
(757) 300-7099
NPI assigned
May 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Authorized official

Name
Yaisa Goodwin
Title
Credentialing Consultant
Phone
(757) 339-8798

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 0904009647 VA Primary

Addresses

Primary practice location

104 Wexford CT
Yorktown, VA 23693-4597

Mailing address

104 Wexford CT
Yorktown, VA 23693-4597
Phone (757) 300-7099

Other identifiers 1

IdentifierTypeStateIssuer
1750823803MedicaidVA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525132800000",
    "number": "1861980260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WEXFORD CT",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236934597",
            "telephone_number": "757-300-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WEXFORD CT",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236934597",
            "telephone_number": "757-300-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPIRITUALLY INSPIRED TRANSFORMATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-01",
        "last_updated": "2018-05-01",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "YAISA",
        "authorized_official_title_or_position": "CREDENTIALING CONSULTANT",
        "authorized_official_telephone_number": "757-339-8798"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750823803",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorktown, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; 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.