Mary Mischtschuk, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904005510 Issued in VA

Practice address

12721 Darby Brook CT Ste 102
Woodbridge, VA 22192-2408

Phone

(703) 879-5144

Fax

(703) 879-5860

NPI assigned

Nov 23, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Skyline Wellness Center

  • Chiropractor
  • Alexandria, VA
  • NPI 1760623201
  NPD (past)

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507334400000",
    "number": "1043293012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 KING ST",
            "address_2": "SUITE 130",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021503",
            "telephone_number": "703-879-5144",
            "fax_number": "703-879-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12721 DARBY BROOK CT STE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922408",
            "telephone_number": "703-879-5144",
            "fax_number": "703-879-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISCHTSCHUK",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2017-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10740",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50081376",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mind Care Professional Limited Liability Company
• Mind Perception Therapy
• Mindful Athletes
• Marlene Mireles, PT, DPT
• Lisa M Miroff, DPT
• Misk LLC (lifetime pharmacy and compounding)
• Karley Miskimens, MS, CCC- SLP
• Kristie Mitchell, M.D.
• Lois A.Brandchaft Mitchell, LPC
• Martina Janel Mitchell

• Clinical Social Worker in Woodbridge, VA
• Providers in Woodbridge, 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 Oct 7, 2017; 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.