Brooke Lori Johnson, LCSW
Individual provider Active NPI Clinical Social Worker · Fairfax, VA
NPI 1265724009 · NPPES record last updated Sep 7, 2021
Key facts
- NPI
- 1265724009
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 0904007293 (VA)
- Practice address
- 10615 Judicial Dr Ste 301
Fairfax, VA 22030-7501 - Phone
- (703) 424-0410
- NPI assigned
- May 12, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
105 N Virginia Ave
Suite 306
Falls Church, VA 22046-3342
Phone (703) 844-2539
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210907001966 | DC | Practitioner - Clinical Social Worker | 9931371101 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Virginia Older Adult Counseling | Current |
Accepting new patients | |
| Brooke Johnson, LCSW, PLLC | Clinical | Current |
Accepting new patients |
| Capital Palliative Care Consultants, LLC | Past |
Accepting new patients |
Locations
10615 Judicial Dr
Ste 301
Fairfax, VA 22030
Phone (703) 424-0410
105 N Virginia Ave
Ste 306
Falls Church, VA 22046
Phone (703) 844-2539
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904007293 | VA | Yes |
Addresses
Primary practice location
10615 Judicial Dr Ste 301
Fairfax, VA 22030-7501
Mailing address
136 N Park Dr
Arlington, VA 22203-2621
Phone (301) 661-3669
Other practice location 1
2900 Telestar Ct
Falls Church, VA 22042-1206
Phone (703) 538-2065 ext. 3146
Other names
- Brooke Lori Andrews
Other providers in Fairfax, VA
- Johnny K. Nam, D.D.S., P.C.
- Johnson and Knox Dentcare Associates
- Abigail Davis Johnson
- Arrykka Johnson
- Brooke Leigh Johnson
- Chavone Johnson
- Christopher David Johnson
- Christopher Robert Johnson
- Clarion Ellis Johnson
- Derek K Johnson
All providers in Fairfax, VA · Clinical Social Worker in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.