Individual provider Active NPI

Andrea Christina Vennable, LCSWA

  • Clinical Social Worker
  • Winston Salem, NC
National Provider Identifier
1972198596
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P015619 Issued in NC
Practice address
8007 N Point Blvd Ste a
Winston Salem, NC 27106-3268
Phone
(866) 700-1606
NPI assigned
Mar 5, 2021
Last updated
Mar 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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 P015619 NC Primary

Addresses

Primary practice location

8007 N Point Blvd Ste a
Winston Salem, NC 27106-3268

Mailing address

8007 N Point Blvd Ste a
Winston Salem, NC 27106-3268
Phone (866) 700-1606

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
P015619NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1972198596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8007 N POINT BLVD STE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063268",
            "telephone_number": "866-700-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8007 N POINT BLVD STE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063268",
            "telephone_number": "866-700-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENNABLE",
        "first_name": "ANDREA",
        "middle_name": "CHRISTINA",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P015619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.