Individual provider Active NPI

Alex Mauricio Mejia, LCSW

  • Clinical Social Worker
  • Woodbridge, VA
National Provider Identifier
1487128138
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904010729 Issued in VA
Practice address
15941 Donald Curtis Dr Ste 200
Woodbridge, VA 22191-4257
Phone
(703) 792-4900
Fax
(703) 792-5699
NPI assigned
Jan 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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 0904010729 VA Primary

Addresses

Primary practice location

15941 Donald Curtis Dr Ste 200
Woodbridge, VA 22191-4257

Mailing address

8300 Cannister CT
Fredericksburg, VA 22407-1907
Phone (703) 221-3348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904010729VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1487128138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 CANNISTER CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224071907",
            "telephone_number": "703-221-3348",
            "fax_number": "703-221-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15941 DONALD CURTIS DR STE 200",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221914257",
            "telephone_number": "703-792-4900",
            "fax_number": "703-792-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "ALEX",
        "middle_name": "MAURICIO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.