Individual provider Active NPI

Jessica D Fratrik, LCSW

  • Clinical Social Worker
  • Lynchburg, VA
National Provider Identifier
1184737124
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904006360 Issued in VA
Practice address
2215 Langhorne Rd
Suite 104
Lynchburg, VA 24501-1121
Phone
(434) 948-3810
Fax
(434) 948-4918
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0904006360 VA Primary

Addresses

Primary practice location

2215 Langhorne Rd
Suite 104
Lynchburg, VA 24501-1121

Mailing address

2215 Langhorne Rd
Suite 104
Lynchburg, VA 24501-1121

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904006360VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184737124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 LANGHORNE RD",
            "address_2": "SUITE 104",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011121",
            "fax_number": "434-948-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 LANGHORNE RD",
            "address_2": "SUITE 104",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011121",
            "telephone_number": "434-948-3810",
            "fax_number": "434-948-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRATRIK",
        "first_name": "JESSICA",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.