MR. EDWARD JOHN WHITACRE (LCSW) – Clinical Social Worker, NPI 1417965583

MR. EDWARD JOHN WHITACRE (LCSW) is a healthcare provider. based in Williamsburg, Virginia. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 0904002390 (VA). The NPI Number for MR. EDWARD JOHN WHITACRE (LCSW) is 1417965583

Main info

Male
Sole Proprietor
38 Years Of Experience
Accepts Medicare Assignment
Name
MR. EDWARD JOHN WHITACRE (LCSW)
NPI
1417965583
Phone
(757) 566-4824
Address
4657 MASSENA DR
Enumeration Date
4 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7578731736
Graduation Year
1988 (38 years ago)
PAC ID
7113186503
Group Practice PAC ID
1052209954
Professional Enrollment ID
I20120305000048
Address ID
VA236064236NE11825DRXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,023 CLINICAL SOCIAL WORKER in VA

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Provider Addresses for MR. EDWARD JOHN WHITACRE (LCSW)

  • 4657 MASSENA DR

    WILLIAMSBURG, VA 231881261

    Phone: (757) 566-4824

    Type: Mailing

  • 11825, Rock Landing Drive, City Center, Oyster Point, Newport News, Virginia, 23606, United States

    THE JAMES BUILDING

    NEWPORT NEWS, VA 236064236

    Phone: (757) 873-1736

    Fax: (757) 873-1028

    Type: Location

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: 2012-03-05

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
I20120305000048IClinical 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 hour12313$0
View full utilization report →

Insurance plans in this area (ZIP 23188)

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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: 1052209954View full group profile
NameSpecialtyState
Nurse PractitionerVA
Marriage And Family TherapistVA
-VA
Marriage And Family TherapistVA
Clinical Social WorkerCO
Clinical Social WorkerVA
Mental Health CounselorVA
Marriage And Family TherapistVA
Clinical Social WorkerVA
Marriage And Family TherapistVA

Reviews

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Frequently asked questions

What number should I use to identify MR. EDWARD JOHN WHITACRE (LCSW) for billing?
Administrative and clinical systems typically use NPI 1417965583 for MR. EDWARD JOHN WHITACRE (LCSW).
Does the public listing show MR. EDWARD JOHN WHITACRE (LCSW) as active?
MR. EDWARD JOHN WHITACRE (LCSW)'s NPI record reflects an active status in NPPES.
What services align with MR. EDWARD JOHN WHITACRE (LCSW)'s listing?
MR. EDWARD JOHN WHITACRE (LCSW)'s public classification highlights Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What city is tied to MR. EDWARD JOHN WHITACRE (LCSW)?
The directory associates MR. EDWARD JOHN WHITACRE (LCSW) with Williamsburg, Virginia. Check all listed addresses for suites or satellite offices.
Why is information missing for MR. EDWARD JOHN WHITACRE (LCSW)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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