Active NPI
Jessie Alexandra Patton, LCSW
- Clinical Social Worker
- Falls Church, VA
National Provider Identifier
1326652819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904010732
- Practice address
- 6063 Arlington Blvd
Falls Church, VA 22044-2721 - Phone
- (703) 533-3930
- NPI assigned
- Sep 2, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 0904010732 | VA | Primary |
Addresses
Primary practice location
6063 Arlington Blvd
Falls Church, VA 22044-2721
Mailing address
3978 Norton PL
Fairfax, VA 22030-3734
Phone (443) 871-4946
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 21, 2024 through May 21, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904010732 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599004800000",
"number": "1326652819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3978 NORTON PL",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220303734",
"telephone_number": "443-871-4946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6063 ARLINGTON BLVD",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220442721",
"telephone_number": "703-533-3930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTON",
"first_name": "JESSIE",
"middle_name": "ALEXANDRA",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-02",
"last_updated": "2020-09-02",
"certification_date": "2020-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904010732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Falls Church, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.