Active NPI
Aryn Leigh Rosner Jentz, LCSW
- Clinical Social Worker
- Ashland, VA
National Provider Identifier
1457767014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904008644
- 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
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 | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004945352 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0904008644 | VA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supportive Care of Maryland LLC | Current | 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.
-
- Community/Behavioral Health Agency
- Chesterfield, VA
- NPI 1538605613
-
- Nursing Care Agency
- Chesterfield, VA
- NPI 1609253897
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.