Individual provider Active NPI

Steven E Frutos, LCSW

  • Clinical Social Worker
  • Alexandria, VA
National Provider Identifier
1003069675
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904006961 Issued in VA
Practice address
4850 Mark Center Dr
Alexandria, VA 22311-1882
Phone
(703) 746-3400
NPI assigned
Oct 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS22881 CA
Clinical Social Worker 1041C0700X 0904006961 VA Primary

Addresses

Primary practice location

4850 Mark Center Dr
Alexandria, VA 22311-1882

Mailing address

4105 Conrad Rd
Alexandria, VA 22312-1104
Phone (703) 746-3400

Other identifiers 1

IdentifierTypeStateIssuer
004945026MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS22881CAMDClinical Social Worker
0904006961VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
City of Alexandria Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1003069675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 CONRAD RD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223121104",
            "telephone_number": "703-746-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 MARK CENTER DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111882",
            "telephone_number": "703-746-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUTOS",
        "first_name": "STEVEN",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS22881",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945026",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.