Jennifer Smoot Gisin, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

3611 Chain Bridge Rd Ste D
Fairfax, VA 22030-3246

Phone

(703) 380-9045

NPI assigned

Sep 27, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1104597459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 CHAIN BRIDGE RD STE D",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303246",
            "telephone_number": "703-380-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 CHAIN BRIDGE RD STE D",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303246",
            "telephone_number": "703-380-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GISIN",
        "first_name": "JENNIFER",
        "middle_name": "SMOOT",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "crossroadsfamilycounselingcenter.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3611 Chain Bridge Rd Ste D",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220303246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Fairfax, VA
• Providers in Fairfax, 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 Sep 27, 2021; 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.