Keisha Lavon Dennis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904018522 Issued in VA

Practice address

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Phone

(210) 539-9582

NPI assigned

Jun 9, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prince William County Community Services BoardGroup PAC ID 7113912973, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Prince William County Community Services Board

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manassas, VA
  • NPI 1053402800
  Medicare reassignment Care Compare group NPD
• Mended Wings, LLC

  dba Mended Wings Academy

  • Mental Health Counselor
  • Richmond, VA
  • NPI 1104757681
  NPD Authorized official
• Prince William County

  dba Prince William County Department of Fire and Rescue

  • Ambulance
  • Prince William, VA
  • NPI 1235437385
  NPD

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1992699383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-539-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-539-9582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "KEISHA",
        "middle_name": "LAVON",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "119776",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904018522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey D Dellavolpe, MD
• Bonnie Jeanne Demars
• Sheri Lynn Demartelaere, M.D.
• Richelle Ramirez Demotica, CRNA
• Deanna Catherine Denman, PHD
• Sharon Denice Denson, PA
• Dimitar Dentchev, M.D.
• Paul M Dente Ellis, D.O.
• Darlene Deters
• Corinne Krystine Bessette Devlin, MSN, RN, FNP-BC

• Clinical Social Worker in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.