Individual provider Active NPI

Jennifer Ann Stump, MSW, LICSW

  • Clinical Social Worker
  • Winchester, VA
National Provider Identifier
1063718716
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008944 Issued in VA
Practice address
123 S Loudoun St
Winchester, VA 22601-4721
Phone
(540) 431-5909
Fax
(540) 431-5366
NPI assigned
Jan 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC50080609 DC
Clinical Social Worker 1041C0700X DP00943751 WV
Clinical Social Worker 1041C0700X 0904008944 VA Primary

Addresses

Primary practice location

123 S Loudoun St
Winchester, VA 22601-4721

Mailing address

123 S Loudoun St
Winchester, VA 22601-4721
Phone (240) 979-8640

Other identifiers 1

IdentifierTypeStateIssuer
1063718716MedicaidWV

Other names 1

  • Ms. Jennifer Ann Malone Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC50080609DCMDClinical Social Worker
0904008944VAMDClinical Social Worker
DP00943751WVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Counseling and Growth, PLC Past Accepting new patients
Roxanne Ostlund LPC PLCC PastSince Aug 24, 2017 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1063718716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 S LOUDOUN ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226014721",
            "telephone_number": "240-979-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S LOUDOUN ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226014721",
            "telephone_number": "540-431-5909",
            "fax_number": "540-431-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUMP",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-28",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50080609",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00943751",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063718716",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MALONE",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "MSW,LGSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winchester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.