Therese P. Photiadis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904002275 Issued in VA

Practice address

1485 Chain Bridge Rd
204
McLean, VA 22101-4501

Phone

(703) 734-1477

Fax

(703) 734-6333

NPI assigned

May 3, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316169642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 CHAIN BRIDGE RD",
            "address_2": "204",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221014501",
            "telephone_number": "703-734-1477",
            "fax_number": "703-734-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 CHAIN BRIDGE RD",
            "address_2": "204",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221014501",
            "telephone_number": "703-734-1477",
            "fax_number": "703-734-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHOTIADIS",
        "first_name": "THERESE",
        "middle_name": "P.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904002275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in McLean, VA
• Providers in McLean, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.