Active NPI
Jean Bond, LCSW
- Clinical Social Worker
- Fairfax, VA
National Provider Identifier
1487197877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904009711
- Practice address
- 3251 Old Lee Hwy Ste 402
Fairfax, VA 22030-1504 - Phone
- (703) 859-4608
- NPI assigned
- Dec 2, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW.09924544 | CO | |
| Clinical Social Worker | 1041C0700X | 0904009711 | VA | Primary |
Addresses
Primary practice location
3251 Old Lee Hwy Ste 402
Fairfax, VA 22030-1504
Mailing address
3251 Old Lee Hwy Ste 402
Fairfax, VA 22030-1504
Phone (703) 859-4608
Other names 1
- Jean Wood
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 2, 2022 through Mar 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW.09924544 | CO | MD | Clinical Social Worker |
| 0904009711 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554249600000",
"number": "1487197877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3251 OLD LEE HWY STE 402",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220301504",
"telephone_number": "703-859-4608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3251 OLD LEE HWY STE 402",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220301504",
"telephone_number": "703-859-4608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOND",
"first_name": "JEAN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-02",
"last_updated": "2019-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "CSW.09924544",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904009711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JEAN",
"last_name": "WOOD",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.