Individual provider Active NPI

Vibha Thukral, LCSW

  • Clinical Social Worker
  • Sterling, VA
National Provider Identifier
1417664947
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904019492 Issued in VA
Practice address
22375 Broderick Dr Ste 125
Sterling, VA 20166-9345
Phone
(571) 375-0214
NPI assigned
Nov 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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 0904019492 VA Primary

Addresses

Primary practice location

22375 Broderick Dr Ste 125
Sterling, VA 20166-9345

Mailing address

18190 Camdenhurst Dr
Gainesville, VA 20155-6240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20260102001365 VA Practitioner - Clinical Social Worker 2365938917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prince William County Community Services BoardGroup PAC ID 7113912973, 57 clinicians

Practice addresses (Care Compare)

7969 Ashton Ave
Manassas, VA 20109-2885
Phone (703) 792-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904019492VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prince William County Community Services Board CurrentSince Nov 12, 2025 Accepting new patients
Prince William County CurrentSince Nov 12, 2025 Accepting new patients

Locations

7969 Ashton Ave
Manassas, VA 20109
Phone (703) 792-7826

14011 Worth Ave
Ste 110
Woodbridge, VA 22192

Organizations & group practices 2

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": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1417664947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18190 CAMDENHURST DR",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201556240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22375 BRODERICK DR STE 125",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201669345",
            "telephone_number": "571-375-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUKRAL",
        "first_name": "VIBHA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-03",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904019492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

Verify at the official NPI Registry.