Elizabeth San Pedro, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904006893 Issued in VA

Practice address

4850 Mark Center Dr
Alexandria, VA 22311-1882

Phone

(703) 746-3400

Fax

(703) 746-3464

NPI assigned

Oct 30, 2008

Last updated

Jun 13, 2024By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City of AlexandriaGroup PAC ID 0941195374, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• City of Alexandria

  dba Alexandria Community Services Board

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Alexandria, VA
  • NPI 1447279658

  DC

  Medicare reassignment Care Compare group NPD
• City of Alexandria

  dba Alexandria Fire Department

  • Ambulance
  • Alexandria, VA
  • NPI 1902970593
  NPD
• Fairfax County, Virginia

  dba Fairfax-Falls Church Community Services Board

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fairfax, VA
  • NPI 1154356244
  NPD (past)

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

{
    "created_epoch": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1326291659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 POWELL LN",
            "address_2": "#616",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220413687",
            "telephone_number": "703-746-3444",
            "fax_number": "703-746-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 MARK CENTER DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111882",
            "telephone_number": "703-746-3400",
            "fax_number": "703-746-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN PEDRO",
        "first_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945026",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sameday Cardiovascular Care LLC
• Bahareh Sameti
• Chelsea Samo-Lipman, PA-C
• Kanchan Samtani, PHARM.D.
• Samtha Brotherton, DDS., PC
• Lourdes San Pedro, LCSW
• Bertha Elvira Sanchez Valdivieso, MD
• Marcos Dionisio Sanchez, DDS
• Sanctuary Care
• Lauren Sander, MS RD CSSD LD

• Clinical Social Worker in Alexandria, VA
• Providers in Alexandria, 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 Jun 13, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.