MR. JOHN JEFFREY WILLIS (LCSW) – Clinical Social Worker, NPI 1174560189

MR. JOHN JEFFREY WILLIS (LCSW) is a healthcare provider. based in Richmond, Virginia. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 0904002484 (VA). The NPI Number for MR. JOHN JEFFREY WILLIS (LCSW) is 1174560189

Main info

Male
36 Years Of Experience
Accepts Medicare Assignment
Name
MR. JOHN JEFFREY WILLIS (LCSW)
NPI
1174560189
Phone
(804) 270-1124
Address
2305 N PARHAM RD
Enumeration Date
31 May 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8042884881
Graduation Year
1990 (36 years ago)
PAC ID
2961663943
Group Practice PAC ID
2860394178
Professional Enrollment ID
I20120418000783
Address ID
VA232944422RI2810XRDXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,023 CLINICAL SOCIAL WORKER in VA

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Provider Addresses for MR. JOHN JEFFREY WILLIS (LCSW)

  • Virginia Tech - Richmond Center, 2810, North Parham Road, English Hills, Henrico County, Virginia, 23294, United States

    SUITE 3

    RICHMOND, VA 232293156

    Phone: (804) 270-1124

    Fax: (804) 270-2090

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-04-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120418000783IClinical Social WorkerVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour10811$0
View full utilization report →

Insurance plans in this area (ZIP 23229)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860394178View full group profile
NameSpecialtyState
Mental Health CounselorVA
Nurse PractitionerMD
P S Y C H I A T R YVA
Nurse PractitionerUT
P S Y C H I A T R YVA
Nurse PractitionerVA
Psychiatry, NeurologyVA
Physician AssistantVA
Nurse PractitionerVA
-VA

Reviews

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Frequently asked questions

Where can patients find MR. JOHN JEFFREY WILLIS (LCSW)'s NPI?
You can confirm MR. JOHN JEFFREY WILLIS (LCSW) with NPI 1174560189; it appears in the national provider directory.
Is MR. JOHN JEFFREY WILLIS (LCSW) currently active in the NPI registry?
CMS-published data lists MR. JOHN JEFFREY WILLIS (LCSW) as an active registrant.
What kind of provider is MR. JOHN JEFFREY WILLIS (LCSW)?
The page reflects Clinical Social Worker for MR. JOHN JEFFREY WILLIS (LCSW). Clinical services aligned with this taxonomy classification.
Where is MR. JOHN JEFFREY WILLIS (LCSW)'s primary listing?
We display Richmond, Virginia because that is what the record indicates for MR. JOHN JEFFREY WILLIS (LCSW).
How can I contact MR. JOHN JEFFREY WILLIS (LCSW)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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