Active NPI
Abigail Caryssa Brown, LCSW
- Clinical Social Worker
- Callaway, VA
National Provider Identifier
1871073064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904015826
- Practice address
- 855 Algoma Rd
Callaway, VA 24067-3407 - Phone
- (920) 559-8502
- NPI assigned
- Aug 16, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | 0904015826 | VA | Primary |
Addresses
Primary practice location
855 Algoma Rd
Callaway, VA 24067-3407
Mailing address
855 Algoma Rd
Callaway, VA 24067-3407
Phone (920) 559-8502
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0904015826 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707091200000",
"number": "1871073064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 ALGOMA RD",
"city": "CALLAWAY",
"state": "VA",
"postal_code": "240673407",
"telephone_number": "920-559-8502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 ALGOMA RD",
"city": "CALLAWAY",
"state": "VA",
"postal_code": "240673407",
"telephone_number": "920-559-8502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "ABIGAIL",
"middle_name": "CARYSSA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-16",
"last_updated": "2024-02-05",
"certification_date": "2024-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904015826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Callaway, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.