Active NPI
Stephanie Craddock, LCSW
- Clinical Social Worker
- Chantilly, VA
National Provider Identifier
1497830665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904006829
- Practice address
- 26207 Lands End Drive
Chantilly, VA 20152-5627 - Phone
- (732) 266-6258
- Fax
- (732) 235-2408
- NPI assigned
- Oct 26, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904006829 | Primary |
Addresses
Primary practice location
26207 Lands End Drive
Chantilly, VA 20152-5627
Mailing address
26207 Lands End Drive
Chantilly, VA 20152-5627
Phone (732) 266-6258
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687996800000",
"number": "1497830665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26207 LANDS END DRIVE",
"city": "CHANTILLY",
"state": "VA",
"postal_code": "201525627",
"telephone_number": "732-266-6258",
"fax_number": "732-235-2408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26207 LANDS END DRIVE",
"city": "CHANTILLY",
"state": "VA",
"postal_code": "201525627",
"telephone_number": "732-266-6258",
"fax_number": "732-235-2408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRADDOCK",
"first_name": "STEPHANIE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2023-06-29",
"certification_date": "2023-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": "0904006829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chantilly, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.