Active NPI
Lyanne Trumbull, LCSW
- Clinical Social Worker
- Chantilly, VA
National Provider Identifier
1508055674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904003724
- Practice address
- 14150 Parkeast Cir
Suite 200
Chantilly, VA 20151-2295 - Phone
- (703) 968-4000
- NPI assigned
- Oct 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 0904003724 | VA | Primary |
Addresses
Primary practice location
14150 Parkeast Cir
Suite 200
Chantilly, VA 20151-2295
Mailing address
14150 Parkeast Cir
Suite 200
Chantilly, VA 20151-2295
Phone (703) 968-4000
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairfax County, Virginia | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fairfax, VA
- NPI 1154356244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192406400000",
"number": "1508055674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14150 PARKEAST CIR",
"address_2": "SUITE 200",
"city": "CHANTILLY",
"state": "VA",
"postal_code": "201512295",
"telephone_number": "703-968-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14150 PARKEAST CIR",
"address_2": "SUITE 200",
"city": "CHANTILLY",
"state": "VA",
"postal_code": "201512295",
"telephone_number": "703-968-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUMBULL",
"first_name": "LYANNE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-15",
"last_updated": "2007-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904003724",
"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 Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.