Individual provider Active NPI

Sandra Marie Garza, LCSW

  • Clinical Social Worker
  • Fairfax, VA
National Provider Identifier
1548651375
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008725 Issued in VA
Practice address
4110 Chain Bridge Rd
Fairfax, VA 22030-4020
Phone
(703) 246-2501
NPI assigned
Feb 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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 0904008725 VA Primary

Addresses

Primary practice location

4110 Chain Bridge Rd
Fairfax, VA 22030-4020

Mailing address

4110 Chain Bridge Rd
Fairfax, VA 22030-4020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20151215001200 DC Practitioner - Clinical Social Worker 0840519088 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904008725VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax County, Virginia CurrentSince Sep 1, 2023 Accepting new patients

Locations

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031
Phone (703) 289-7599

12011 Government Center Pkwy
Ste 836
Fairfax, VA 22035
Phone (703) 324-7017

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": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1548651375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 CHAIN BRIDGE RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 CHAIN BRIDGE RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304020",
            "telephone_number": "703-246-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARZA",
        "first_name": "SANDRA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-16",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.