Physician Compare National (NPI:1407187263)

HEALTHCARE PROVIDER: KEVIN STEVEN CHILDS LCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1407187263
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3476737388
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110418000305
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHILDS
	Individual professional last name
Provider First Name	KEVIN
	Individual professional first name
Provider Middle Name	STEVEN
	Individual professional middle name
Provider Name Suffix Text	SR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2003
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	5301 PROVIDENCE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 40
	Group Practice or individual's line 2 address
City	VIRGINIA BEACH
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	234644128
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7576068282
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y