Jodi Eileen Brayton, MSW LICSW LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904006719 Issued in VA

Practice address

6829 Elm St
Suite 300
MC Lean, VA 22101-3884

Phone

(703) 532-4892

Fax

(703) 237-3105

NPI assigned

Oct 3, 2007

Sex

Female

Sole proprietor

No

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

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.

Opted out of Medicare

Yes, effective Jul 1, 2025 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1508053547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6829 ELM ST",
            "address_2": "SUITE 300",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013884",
            "telephone_number": "703-532-4892",
            "fax_number": "703-237-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6829 ELM ST",
            "address_2": "SUITE 300",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013884",
            "telephone_number": "703-532-4892",
            "fax_number": "703-237-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAYTON",
        "first_name": "JODI",
        "middle_name": "EILEEN",
        "credential": "MSW LICSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006719",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50077897",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in MC Lean, VA
• Providers in MC Lean, 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 Sep 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.