Individual provider Active NPI

Cheryl Wietz, LCSW

  • Clinical Social Worker
  • Falls Church, VA
National Provider Identifier
1083894729
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904001342 Issued in VA
Practice address
101 Rowell CT
Suite 300
Falls Church, VA 22046-3126
Phone
(703) 533-1996
Fax
(703) 533-2100
NPI assigned
Nov 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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 0904001342 VA Primary

Addresses

Primary practice location

101 Rowell CT
Suite 300
Falls Church, VA 22046-3126

Mailing address

101 Rowell CT
Suite 300
Falls Church, VA 22046-3126
Phone (703) 533-1996

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
0904001342VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1083894729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ROWELL CT",
            "address_2": "SUITE 300",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463126",
            "telephone_number": "703-533-1996",
            "fax_number": "703-533-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ROWELL CT",
            "address_2": "SUITE 300",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463126",
            "telephone_number": "703-533-1996",
            "fax_number": "703-533-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIETZ",
        "first_name": "CHERYL",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904001342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.