Individual provider Active NPI

Tresha Lanell Eaglin, LCSW, QMHCM

  • Clinical Social Worker
  • Fairfax, VA
National Provider Identifier
1336890649
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904014302 Issued in VA
Practice address
8221 Willow Oaks Corporate Dr
Fairfax, VA 22031-4512
Phone
(404) 216-1463
NPI assigned
Jan 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904014302 VA Primary

Addresses

Primary practice location

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031-4512

Mailing address

410 James CT
Falls Church, VA 22046-4122
Phone (404) 216-1463

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tresha.eaglin@fairfaxcounty.gov Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230203001993 DC Practitioner - Clinical Social Worker 1254703077 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904014302VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax County, Virginia CurrentSince Oct 26, 2022 Accepting new patients

Locations

12011 Government Center Pkwy
Ste 836
Fairfax, VA 22035
Phone (703) 324-7017

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031
Phone (703) 289-7599

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1336890649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 JAMES CT",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220464122",
            "telephone_number": "404-216-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8221 WILLOW OAKS CORPORATE DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314512",
            "telephone_number": "404-216-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGLIN",
        "first_name": "TRESHA",
        "middle_name": "LANELL",
        "name_prefix": "Ms.",
        "credential": "LCSW, QMHCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904014302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tresha.eaglin@fairfaxcounty.gov",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "8221 Willow Oaks Corporate Dr",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220314512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.