Tisa McKenna Pinkerton, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904009000 Issued in VA

Practice address

11204 Waples Mill Rd
Fairfax, VA 22030

Phone

(703) 218-8500

NPI assigned

Nov 21, 2013

Last updated

Jun 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Life Hope Counseling Center LLC

  • Community/Behavioral Health Agency
  • Ashburn, VA
  • NPI 1982105573
  NPD Authorized official

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

{
    "created_epoch": "1384992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1497185805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11204 WAPLES MILL RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306036",
            "telephone_number": "703-218-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11204 WAPLES MILL RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-218-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14540 John Marshall Hwy",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "VA",
            "postal_code": "201551691",
            "country_code": "US",
            "telephone_number": "703-798-0442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14540 John Marshall Hwy",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "VA",
            "postal_code": "201551691",
            "country_code": "US",
            "telephone_number": "703-798-0442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44679 Endicott Dr Ste 412",
            "address_purpose": "LOCATION",
            "city": "Ashburn",
            "state": "VA",
            "postal_code": "201475567",
            "country_code": "US",
            "telephone_number": "703-957-8761",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "621 W Main St",
            "address_purpose": "LOCATION",
            "city": "Purcellville",
            "state": "VA",
            "postal_code": "201323012",
            "country_code": "US",
            "telephone_number": "571-477-1557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINKERTON",
        "first_name": "TISA",
        "middle_name": "MCKENNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-21",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50079120",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaiah Pina
• Stephanie Marie Pina, ND, L.AC
• Victoria Pineiro
• Pineridge Counseling Center
• Alaina Marie Pingelli, PHARMD
• Pinkleaf Relationship & Mental Health Wellness LLC
• Pinnacle Family Practice, LLC
• Maureen Piotrowski
• Catherine M Pipan, M.D.
• Samia Piracha, M.D.

• Clinical Social Worker in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.