James Robert Lippold, LCSW-0904012388

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

090412388 Issued in VA

Practice address

115 Beulah Road, NE
Suite 200-B
Vienna, VA 22180

Phone

(703) 255-7012

Fax

(703) 255-6171

NPI assigned

Dec 7, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Total Health Concepts, LLC

  • Clinical Social Worker
  • Vienna, VA
  • NPI 1316143712
  NPD (past)

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1063018992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 EAST STREET, NE",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "22180",
            "telephone_number": "703-919-1668",
            "fax_number": "703-255-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BEULAH ROAD, NE",
            "address_2": "SUITE 200-B",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "22180",
            "telephone_number": "703-255-7012",
            "fax_number": "703-255-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPOLD",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LCSW-0904012388",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "090412388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL SOCIAL WORKER (LCSW)",
            "identifier": "0904012388",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lilac Healthcare Services Inc
• Elizabeth Lim
• Eunhee Lim
• Hae Eun Lim
• Linda P Nims MD & Assoc
• Gary Lane Litovitz, M.D.
• Merle R Litowitz, PH.D.
• Tianhao Liu
• Zhizhen Liu
• Monica Larwou Lockhart

• Clinical Social Worker in Vienna, VA
• Providers in Vienna, 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 Dec 7, 2020; 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.