Rebecca Stevens Alliss, LCSW

Key facts

NPI

1114016268

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

0904003369 (VA)

Practice address

210 Wirt St SW
Suite 303
Leesburg, VA 20175-2929

Phone

(703) 779-0118

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 11, 2013.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1114016268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 NICKELS DR SW",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "20175",
            "telephone_number": "703-779-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WIRT ST SW",
            "address_2": "SUITE 303",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201752929",
            "telephone_number": "703-779-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLISS",
        "first_name": "REBECCA",
        "middle_name": "STEVENS",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904003369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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