Active NPI
John Luke Driessnack, LCSW
- Clinical Social Worker
- Lovettsville, VA
National Provider Identifier
1326637687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW022296
- Practice address
- 11407 Olde Stone LN
Lovettsville, VA 20180-1871 - Phone
- (240) 422-9689
- NPI assigned
- Jan 12, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW022296 | PA | Primary |
Addresses
Primary practice location
11407 Olde Stone LN
Lovettsville, VA 20180-1871
Mailing address
11407 Olde Stone LN
Lovettsville, VA 20180-1871
Phone (240) 422-9689
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW022296 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713312000000",
"number": "1326637687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11407 OLDE STONE LN",
"city": "LOVETTSVILLE",
"state": "VA",
"postal_code": "201801871",
"telephone_number": "240-422-9689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11407 OLDE STONE LN",
"city": "LOVETTSVILLE",
"state": "VA",
"postal_code": "201801871",
"telephone_number": "240-422-9689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRIESSNACK",
"first_name": "JOHN",
"middle_name": "LUKE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-12",
"last_updated": "2024-04-17",
"certification_date": "2024-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW022296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lovettsville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.