Individual provider Active NPI

Dominique A Danquah

  • Clinical Social Worker
  • Fairfax, VA
National Provider Identifier
1164005617
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904012854 Issued in VA
Practice address
8221 Willow Oaks Corporate Dr Ste 4-425
Fairfax, VA 22031-4512
Phone
(703) 289-7560
Fax
(703) 289-4612
NPI assigned
May 3, 2021
Last updated
Oct 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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 0904012854 VA Primary

Addresses

Primary practice location

8221 Willow Oaks Corporate Dr Ste 4-425
Fairfax, VA 22031-4512

Mailing address

8221 Willow Oaks Corporate Dr Ste 4-425
Fairfax, VA 22031-4512
Phone (703) 289-7560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210729000424 VA Practitioner - Clinical Social Worker 5799188611 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904012854VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prince William County Community Services Board CurrentSince Aug 7, 2021 Accepting new patients
Prince William County CurrentSince Aug 7, 2021 Accepting new patients
Two Rivers Counseling LLC CurrentSince Jul 1, 2025 Accepting new patients
Virginia Oak Counseling, LLC Clinical CurrentSince Nov 20, 2021 Accepting new patients
Inova Health Care Services PastSince Oct 9, 2022 Accepting new patients
Alicia's Place Past Accepting new patients

Locations

312 E Market St
Ste F
Leesburg, VA 20176
Phone (304) 725-7176

7969 Ashton Ave
Manassas, VA 20109
Phone (703) 792-7826

14011 Worth Ave
Ste 110
Woodbridge, VA 22192

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1164005617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 WILLOW OAKS CORPORATE DR STE 4-425",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314512",
            "telephone_number": "703-289-7560",
            "fax_number": "703-289-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8221 WILLOW OAKS CORPORATE DR STE 4-425",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314512",
            "telephone_number": "703-289-7560",
            "fax_number": "703-289-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANQUAH",
        "first_name": "DOMINIQUE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2022-10-06",
        "certification_date": "2022-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904012854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.