Individual provider Active NPI

Susan McKool Pfeffer, LCSW

  • Clinical Social Worker
  • McLean, VA
National Provider Identifier
1023189602
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904005872 Issued in VA
Practice address
6832 Old Dominion Dr
Suite 200
McLean, VA 22101-3887
Phone
(703) 356-5534
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904005872 VA Primary

Addresses

Primary practice location

6832 Old Dominion Dr
Suite 200
McLean, VA 22101-3887

Mailing address

7121 Red Horse Tavern LN
Springfield, VA 22153-1406

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904005872VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023189602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7121 RED HORSE TAVERN LN",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221531406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6832 OLD DOMINION DR",
            "address_2": "SUITE 200",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221013887",
            "telephone_number": "703-356-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEFFER",
        "first_name": "SUSAN",
        "middle_name": "MCKOOL",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.