Individual provider Active NPI

Aryn Leigh Rosner Jentz, LCSW

  • Clinical Social Worker
  • Ashland, VA
National Provider Identifier
1457767014
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008644 Issued in VA
Practice address
629 N Washington Hwy Ste F
Ashland, VA 23005-1326
Phone
(804) 840-3518
NPI assigned
Jul 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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 0904008644 VA Primary

Addresses

Primary practice location

629 N Washington Hwy Ste F
Ashland, VA 23005-1326

Mailing address

19102 Woodsons Mill Rd
Beaverdam, VA 23015-1220
Phone (804) 840-3518

Other identifiers 1

IdentifierTypeStateIssuer
004945352MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141021003220 VA Practitioner - Clinical Social Worker 3375764053
I20220912001124 DC Practitioner - Clinical Social Worker 3375764053 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904008644VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care of Maryland LLC CurrentSince Aug 1, 2022 Accepting new patients
Chesterfield County Mental Health Past Accepting new patients
Chesterfield County Mental Health Past Accepting new patients

Locations

4409 East West Hwy
Riverdale Park, MD 20737
Phone (301) 699-2000

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Organizations & group practices 3

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": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1457767014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19102 WOODSONS MILL RD",
            "city": "BEAVERDAM",
            "state": "VA",
            "postal_code": "230151220",
            "telephone_number": "804-840-3518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 N WASHINGTON HWY STE F",
            "city": "ASHLAND",
            "state": "VA",
            "postal_code": "230051326",
            "telephone_number": "804-840-3518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENTZ",
        "first_name": "ARYN",
        "middle_name": "LEIGH ROSNER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-03",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945352",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, VA

Sources for this page

Verify at the official NPI Registry.