Individual provider Active NPI

Jessica Yamilex Hall, LCSW

  • Clinical Social Worker
  • Woodbridge, VA
National Provider Identifier
1265238190
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904017862 Issued in VA
Practice address
4370 Ridgewood Center Dr
Woodbridge, VA 22192-5348
Phone
(703) 863-8929
Fax
(703) 792-5098
NPI assigned
Feb 21, 2025
Last updated
Jul 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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 0904017862 VA Primary

Addresses

Primary practice location

4370 Ridgewood Center Dr
Woodbridge, VA 22192-5348

Mailing address

191 Somervelle St Apt 106
Alexandria, VA 22304-8212
Phone (703) 867-6980

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
I20250327001159 VA Practitioner - Clinical Social Worker 1052833183 Reassigns benefits to 1 organization
I20260407000648 DC Practitioner - Clinical Social Worker 1052833183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Virginia Commonwealth University, School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2100 Washington Blvd
FL 4
Arlington, VA 22204-5717
Phone (703) 228-1611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904017862VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prince William County Community Services Board CurrentSince Jan 14, 2025 Accepting new patients
Prince William County CurrentSince Jan 14, 2025 Accepting new patients

Locations

7969 Ashton Ave
Manassas, VA 20109
Phone (703) 792-7826

14011 Worth Ave
Ste 110
Woodbridge, VA 22192

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1265238190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 SOMERVELLE ST APT 106",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223048212",
            "telephone_number": "703-867-6980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 RIDGEWOOD CENTER DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925348",
            "telephone_number": "703-863-8929",
            "fax_number": "703-792-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "JESSICA",
        "middle_name": "YAMILEX",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904017862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.