MEDICARE: SHAKEYIA WINSTON MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0906017595	VA

General Provider Information

NPI Number	:	1396687562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAKEYIA WINSTON MSW

Provider Business Mailing Address
First Line	:	1715 MEADOW RD
Second Line	:
City	:	SANDSTON
State	:	VA
Zip	:	23150-4006
Country	:	US
Telephone Number	:	804-442-3116
Fax Number	:

Provider Business Practice Location Address
First Line	:	5511 STAPLES MILL RD STE 200
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-5445
Country	:	US
Telephone Number	:	804-442-3116
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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