Irene Carol Ilachinski, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904006259 Issued in VA

Practice address

10400 Eaton PL
Ste 200
Fairfax, VA 22030-2208

Phone

(703) 497-1771

Fax

(703) 497-1225

NPI assigned

Mar 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 17, 2019 through Oct 17, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Prince William Family Counseling, P.C.

  • Mental Health Counselor
  • Manassas, VA
  • NPI 1205868791
  NPD (past)
• Woodbridge Therapy Group LLC

  • Psychologist
  • Woodbridge, VA
  • NPI 1427421627

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1013047083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 EATON PL STE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302208",
            "telephone_number": "571-989-4494",
            "fax_number": "703-591-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 EATON PL",
            "address_2": "STE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302208",
            "telephone_number": "703-497-1771",
            "fax_number": "703-497-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILACHINSKI",
        "first_name": "IRENE",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1346589587",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "irenei@openbridgescounseling.com",
            "affiliation": "N",
            "endpointDescription": "establish encrypted connection",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10400 EATON PL",
            "address_2": "STE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220302208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ifrc, LLC
• Samone Ighofose, NP-C
• Marianne Ihde
• Magnus Kehinde Ikhinmwin, MD
• Carly Ikuma
• Imago Dei Counseling and Coaching
• Azhar Imam, MD
• Immediate Labs, LLC
• In Home Solutions LLC
• In Step

• Clinical Social Worker in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.