Individual provider Active NPI

Jessica Marie Venglarcik, LICSW, LCSW, MSSA

  • Clinical Social Worker
  • Alexandria, VA
National Provider Identifier
1194339978
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904009009 Issued in VA
Practice address
3846 King St
Alexandria, VA 22302-1906
Phone
(703) 879-4441
Fax
(703) 574-2240
NPI assigned
Aug 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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 LC50078761 DC
Clinical Social Worker 1041C0700X 0904009009 VA Primary

Addresses

Primary practice location

3846 King St
Alexandria, VA 22302-1906

Mailing address

PO Box 16038
Alexandria, VA 22302-8038
Phone (703) 879-4441

Other names 1

  • Jessica Drake Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20221101000033 DC Practitioner - Clinical Social Worker 2062888019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3846 King St
Alexandria, VA 22302-1906
Phone (703) 879-4441

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC50078761DCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Total Alignment Counseling, LLC CurrentSince Jun 22, 2022 Accepting new patients

Locations

3846 King St
Alexandria, VA 22302
Phone (703) 879-4441

Organizations & group practices 1

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": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1194339978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16038",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223028038",
            "telephone_number": "703-879-4441",
            "fax_number": "703-574-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3846 KING ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021906",
            "telephone_number": "703-879-4441",
            "fax_number": "703-574-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENGLARCIK",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "LICSW, LCSW, MSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2021-10-22",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50078761",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "DRAKE",
            "credential": "LICSW, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.