Individual provider Active NPI

Shariff Ruffin, LCSW

  • Clinical Social Worker
  • Manassas, VA
National Provider Identifier
1487242855
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
7987 Ashton Ave
Manassas, VA 20109
Phone
(571) 200-6980
NPI assigned
Jan 1, 2021
Last updated
Jan 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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 NU Primary

Addresses

Primary practice location

7987 Ashton Ave
Manassas, VA 20109

Mailing address

7450 Heritage Village PLZ Unit 101
Gainesville, VA 20155-3091
Phone (571) 991-1268

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.therapyforchangeva.com

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
I20210218000945 VA Practitioner - Clinical Social Worker 6800201161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prince William County Community Services Board CurrentSince Feb 1, 2021 Accepting new patients
Prince William County CurrentSince Feb 1, 2021 Accepting new patients
Gainesville Professional Counseling Center PastSince Feb 1, 2021 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 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1609459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1487242855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 HERITAGE VILLAGE PLZ UNIT 101",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553091",
            "telephone_number": "571-991-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7987 ASHTON AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "20109",
            "telephone_number": "571-200-6980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFIN",
        "first_name": "SHARIFF",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-01",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.therapyforchangeva.com",
            "affiliation": "N",
            "address_1": "9480 Main St # 1049",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220314032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.