Individual provider Active NPI

Jennifer Shotlander, LCSW

  • Clinical Social Worker
  • Alexandria, VA
National Provider Identifier
1053684613
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904006634 Issued in VA
Practice address
919 Duke St
Alexandria, VA 22314-3648
Phone
(703) 400-8340
NPI assigned
Feb 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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 0904006634 VA Primary

Addresses

Primary practice location

919 Duke St
Alexandria, VA 22314-3648

Mailing address

6137 Donival SQ
Alexandria, VA 22315-5266
Phone (703) 700-8340

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
0904006634VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Uplift Behavioral Health PC Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329091200000",
    "number": "1053684613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6137 DONIVAL SQ",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223155266",
            "telephone_number": "703-700-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 DUKE ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223143648",
            "telephone_number": "703-400-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOTLANDER",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-13",
        "last_updated": "2012-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.