Individual provider Active NPI

Janice Lynne Shubert, L.C.S.W.

  • Clinical Social Worker
  • South Riding, VA
National Provider Identifier
1508963141
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904004465 Issued in VA
Practice address
43130 Amberwood PLZ
Suite 140
South Riding, VA 20152-4105
Phone
(703) 348-0030
NPI assigned
Sep 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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 0904004465 VA Primary

Addresses

Primary practice location

43130 Amberwood PLZ
Suite 140
South Riding, VA 20152-4105

Mailing address

905 Ashburn St
Herndon, VA 20170-3304
Phone (703) 318-0662

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
I20170607000506 VA Practitioner - Clinical Social Worker 4981971371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Commonwealth Counseling Associates IncGroup PAC ID 0941288583, 207 clinicians

Practice addresses (Care Compare)

46179 Westlake Dr
Suite 340
Sterling, VA 20165-5874
Phone (804) 207-6737

9202 Ctr Oak CT
Mechanicsville, VA 23116-2744
Phone (804) 207-6737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Counseling Associates Inc Clinical CurrentSince Jun 20, 2023 Accepting new patients

Locations

20925 Professional Plz
Ste 230
Ashburn, VA 20147
Phone (703) 621-7121

9202 Center Oak Ct
Mechanicsvlle, VA 23116
Phone (804) 639-1112

46179 Westlake Dr
Ste 340
Sterling, VA 20165
Phone (703) 621-7121

Interoperability endpoints

  • Direct secure messaging: granatogroup.janiceshubert@144557.advancedmd-direct.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1508963141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 ASHBURN ST",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201703304",
            "telephone_number": "703-318-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43130 AMBERWOOD PLZ",
            "address_2": "SUITE 140",
            "city": "SOUTH RIDING",
            "state": "VA",
            "postal_code": "201524105",
            "telephone_number": "703-348-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUBERT",
        "first_name": "JANICE",
        "middle_name": "LYNNE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904004465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Riding, VA

Sources for this page

Verify at the official NPI Registry.