Individual provider Active NPI

Phylandria Lashay Hudson, LCSW

  • Clinical Social Worker
  • Fairfax, VA
National Provider Identifier
1164762076
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904017046 Issued in VA
Practice address
8221 Willow Oaks Corporate Dr # 4420
Fairfax, VA 22031-4512
Phone
(703) 289-7560
Fax
(703) 204-9001
NPI assigned
Mar 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904017046 VA Primary
Clinical Social Worker 1041C0700X C-5832 MS

Addresses

Primary practice location

8221 Willow Oaks Corporate Dr # 4420
Fairfax, VA 22031-4512

Mailing address

8221 Willow Oaks Corporate Dr # 4420
Fairfax, VA 22031-4512
Phone (703) 289-7560

Other practice location 1

1618 Pear Orchard Pl
Jackson, MS 39211-2206
Phone (601) 942-1129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260429002992 VA Practitioner - Clinical Social Worker 4284870445 Reassigns benefits to 1 organization
I20260430003785 DC Practitioner - Clinical Social Worker 4284870445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8095 Innovation Park Dr
Fairfax, VA 22031-4868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-5832MSMDClinical Social Worker
0904017046VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Behavioral Health, LLC Clinical Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1164762076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 WILLOW OAKS CORPORATE DR # 4420",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314512",
            "telephone_number": "703-289-7560",
            "fax_number": "703-204-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8221 WILLOW OAKS CORPORATE DR # 4420",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314512",
            "telephone_number": "703-289-7560",
            "fax_number": "703-204-9001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1618 Pear Orchard Pl",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392112206",
            "country_code": "US",
            "telephone_number": "601-942-1129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "PHYLANDRIA",
        "middle_name": "LASHAY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-01",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904017046",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C-5832",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.