Individual provider Active NPI

Laura Bennecoff, LCSW

  • Clinical Social Worker
  • Reston, VA
National Provider Identifier
1033975644
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904016442 Issued in VA
Practice address
1850 Cameron Glen Dr Ste 500
Reston, VA 20190-3343
Phone
(703) 559-3000
NPI assigned
Feb 22, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Director of Finance-County of Fairfax VA 176 clinicians

Practice addresses (Care Compare)

1850 Cameron Glen Dr
Suite 500
Reston, VA 20190-3343
Phone (703) 324-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20240402001449 DC Practitioner - Clinical Social Worker 2860830460 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904016442VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax County, Virginia CurrentSince Feb 21, 2024 Accepting new patients

Locations

12011 Government Center Pkwy
Ste 836
Fairfax, VA 22035
Phone (703) 324-7017

1850 Cameron Glen Dr
Ste 600
Reston, VA 20190
Phone (703) 481-4100

1850 Cameron Glen Dr
Ste 500
Reston, VA 20190
Phone (703) 481-4004

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904016442 VA Primary

Addresses

NPPES NPI Registry

Primary practice location

1850 Cameron Glen Dr Ste 500
Reston, VA 20190-3343

Mailing address

1850 Cameron Glen Dr Ste 500
Reston, VA 20190-3343
Phone (703) 559-3000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 22, 2024.

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1033975644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 CAMERON GLEN DR STE 500",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903343",
            "telephone_number": "703-559-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 CAMERON GLEN DR STE 500",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903343",
            "telephone_number": "703-559-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNECOFF",
        "first_name": "LAURA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-22",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904016442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.