MEDICARE: BRONWYN PHILIPS

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	0904019212	VA

General Provider Information

NPI Number	:	1043177645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRONWYN PHILIPS

Provider Business Mailing Address
First Line	:	2104 ROCKLAND CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-7313
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2641 NIMMO PKWY
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-9134
Country	:	US
Telephone Number	:	757-263-3100
Fax Number	:

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

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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Directions to “ BRONWYN PHILIPS ” Practice Location

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