Monique Regina Preston, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0903002398 Issued in VA

Practice address

1681 Bayfield Way
Reston, VA 20194-1513

Phone

(703) 387-6979

NPI assigned

Jun 11, 2021

Last updated

Aug 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1114595634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1681 BAYFIELD WAY",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201941513",
            "telephone_number": "703-387-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1681 BAYFIELD WAY",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201941513",
            "telephone_number": "703-387-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "MONIQUE",
        "middle_name": "REGINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-11",
        "last_updated": "2023-08-15",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904013001",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0903002398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL SOCIAL WORK LICENSE",
            "identifier": "0904013001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Reston, VA
• Providers in Reston, 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 Aug 15, 2023; 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.