Deborah Ann Jockin, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904-004481 Issued in VA

Practice address

312 Progress St
Suite 200
Fredericksburg, VA 22401-3356

Phone

(540) 310-0797

Fax

(540) 310-0791

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Deborah Ann Hudak Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215014576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 W HARRISON CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224071905",
            "telephone_number": "540-786-3978",
            "fax_number": "540-310-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 PROGRESS ST",
            "address_2": "SUITE 200",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013356",
            "telephone_number": "540-310-0797",
            "fax_number": "540-310-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOCKIN",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904-004481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "130640",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "209123",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8922390",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "209122",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5394030",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "HUDAK",
            "middle_name": "ANN",
            "credential": "L.C.S.W.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelley Marie Jimenez
• Maria Alice A Jimenez, LPC
• Amy Kristen Jindra, LPC
• Jonathan Jo
• Joanne Cozzati LCSW PLLC
• Joe T. Johnson, LCSW LLC
• Eshe Johari
• John S Moss MD P L L C
• John W Cook DPM, LTD
• Stephanie Johnican, PHARMD

• Clinical Social Worker in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Clinical Social Worker in Virginia

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.