Active NPI
Rose Desdunes, LCSW
- Clinical Social Worker
- Woodbridge, VA
National Provider Identifier
1023840071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904016584
- Practice address
- 14497 Potomac Mills Rd # 1257
Woodbridge, VA 22192-6807 - Phone
- (571) 285-2707
- NPI assigned
- Aug 19, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904016584 | VA | Primary |
Addresses
Primary practice location
14497 Potomac Mills Rd # 1257
Woodbridge, VA 22192-6807
Mailing address
14497 Potomac Mills Rd # 1257
Woodbridge, VA 22192-6807
Phone (571) 285-2707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904016584 | VA | MD | Clinical Social Worker |
Networks
- devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727654400000",
"number": "1023840071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14497 POTOMAC MILLS RD # 1257",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221926807",
"telephone_number": "571-285-2707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14497 POTOMAC MILLS RD # 1257",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221926807",
"telephone_number": "571-285-2707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESDUNES",
"first_name": "ROSE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-19",
"last_updated": "2024-09-30",
"certification_date": "2024-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904016584",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.