Leticia Salo Isidro-Clancy, MA, LPC-MFT, LADC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

37PC00078400 Issued in NJ

Practice address

9300 Dewitt Loop, River Pavilion 2ND Floor R2.301
Fort Belvoir Community Hospital
Fort Belvoir, VA 22060

Phone

(571) 231-1292

Fax

(571) 231-1283

NPI assigned

Feb 15, 2007

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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433894400000",
    "number": "1043353576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8906 BLUFFWOOD LN",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207446764",
            "telephone_number": "571-231-1292",
            "fax_number": "571-231-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP, RIVER PAVILION 2ND FLOOR R2.301",
            "address_2": "FORT BELVOIR COMMUNITY HOSPITAL",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "22060",
            "telephone_number": "571-231-1292",
            "fax_number": "571-231-1283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISIDRO-CLANCY",
        "first_name": "LETICIA",
        "middle_name": "SALO",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC-MFT, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2015-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NJ",
            "license": "37PC00078400",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00078400",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00082200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deatra Idlet-Battle
• Ryan Christopher Inocencio, M.D.
• Stefan Inouye
• Macon Loshawn Irick, LCSW
• Georgina Irondi, LCSW-C
• Carol Bowser Jackson, RN
• Regina Lynne Jacobs, RDH
• John M Jacocks, M.D.
• Ashley Alexandra Jaeger, M.D.
• Bonnie Freid James, PA-C

• Marriage & Family Therapist in Fort Belvoir, VA
• Providers in Fort Belvoir, VA by specialty
• Marriage & Family Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; 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.