Individual provider Active NPI

Jennifer Huaman Sevillano, LCSW

  • Clinical Social Worker
  • Leesburg, VA
National Provider Identifier
1538057997
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904018676 Issued in VA
Practice address
102 Heritage Way NE Ste 302
Leesburg, VA 20176-4544
Phone
(703) 771-5100
Fax
(703) 777-0170
NPI assigned
Jun 25, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 0904018676 VA Primary

Addresses

Primary practice location

102 Heritage Way NE Ste 302
Leesburg, VA 20176-4544

Mailing address

102 Heritage Way NE Ste 302
Leesburg, VA 20176-4544
Phone (703) 771-5100

Other names 1

  • Jennifer Tiffany Huaman Former name

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
I20250818002474 VA Practitioner - Clinical Social Worker 9234638107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

906 Trailview Blvd SE
Leesburg, VA 20175-4415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904018676VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Loudoun, Virginia CurrentSince Aug 4, 2025 Accepting new patients
County of Loudoun, Virginia Multi-Specialty CurrentSince Aug 4, 2025 Accepting new patients
County of Loudoun, Virginia Past Accepting new patients

Locations

102 Heritage Way NE
Ste 302
Leesburg, VA 20176
Phone (703) 771-5155

906 Trailview Blvd SE
Leesburg, VA 20175
Phone (703) 727-1640

102 Heritage Way NE
Ste 102
Leesburg, VA 20176
Phone (703) 771-5155

906 Trailview Blvd SE
Ste C
Leesburg, VA 20175
Phone (571) 583-3323

21641 Ridgetop Cir
Ste 210
Sterling, VA 20166
Phone (571) 541-8727

Organizations & group practices 3

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": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1538057997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HERITAGE WAY NE STE 302",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764544",
            "telephone_number": "703-771-5100",
            "fax_number": "703-777-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HERITAGE WAY NE STE 302",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764544",
            "telephone_number": "703-771-5100",
            "fax_number": "703-777-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVILLANO",
        "first_name": "JENNIFER",
        "middle_name": "HUAMAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904018676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HUAMAN",
            "middle_name": "TIFFANY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.