Active NPI
Ivy Tillman Lomax, LCSW
- Clinical Social Worker
- Woodbridge, VA
National Provider Identifier
1114589991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904008045
- Practice address
- 12890 Harbor Drive
Woodbridge, VA 22192 - Phone
- (571) 316-1059
- NPI assigned
- Jul 2, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | 0904008045 | VA | Primary |
Addresses
Primary practice location
12890 Harbor Drive
Woodbridge, VA 22192
Mailing address
5559 Sherry CT
Woodbridge, VA 22193
Phone (571) 316-1059
Other names 1
- Ms. Ivy Denise Tillman
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | HallCounselingServices.com | ||
| CONNECT URL | HallCounselingServices.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0904008045 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748822400000",
"number": "1114589991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5559 SHERRY CT",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "22193",
"telephone_number": "571-316-1059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12890 HARBOR DRIVE",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "22192",
"telephone_number": "571-316-1059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOMAX",
"first_name": "IVY",
"middle_name": "TILLMAN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-02",
"last_updated": "2025-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904008045",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "HallCounselingServices.com",
"affiliation": "N",
"address_1": "1727 King St Ste 105",
"city": "Alexandria",
"state": "VA",
"country_code": "US",
"postal_code": "223142700",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "HallCounselingServices.com",
"affiliation": "N",
"address_1": "1727 King St Ste 105",
"city": "Alexandria",
"state": "VA",
"country_code": "US",
"postal_code": "223142700",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "IVY",
"last_name": "TILLMAN",
"middle_name": "DENISE",
"prefix": "MS.",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.