Active NPI
Sajjad A Khan, PHD, LCSW
- Clinical Social Worker
- Herndon, VA
National Provider Identifier
1194957704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904007622
- Practice address
- 106 Elden St
Suite 17
Herndon, VA 20170-4872 - Phone
- (703) 787-9090
- Fax
- (703) 787-8845
- NPI assigned
- Aug 14, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904007622 | VA | Primary |
Addresses
Primary practice location
106 Elden St
Suite 17
Herndon, VA 20170-4872
Mailing address
106 Elden St
Suite 17
Herndon, VA 20170-4872
Phone (703) 787-9090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 15, 2024 through Apr 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904007622 | VA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neuroscience, Inc. | Clinical | Past | Accepting new patients |
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": "1250208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392076800000",
"number": "1194957704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 ELDEN ST",
"address_2": "SUITE 17",
"city": "HERNDON",
"state": "VA",
"postal_code": "201704872",
"telephone_number": "703-787-9090",
"fax_number": "703-787-8845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 ELDEN ST",
"address_2": "SUITE 17",
"city": "HERNDON",
"state": "VA",
"postal_code": "201704872",
"telephone_number": "703-787-9090",
"fax_number": "703-787-8845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "SAJJAD",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PHD, LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-14",
"last_updated": "2014-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904007622",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Herndon, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.