Active NPI
Ihsan J Warren, LCSW
- Clinical Social Worker
- Alexandria, VA
National Provider Identifier
1629379722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904007498
- Practice address
- 5290 Shawnee Rd Ste 103
Alexandria, VA 22312-2381 - Phone
- (202) 930-2770
- NPI assigned
- Nov 5, 2010
- Sex
- Male
- 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 | 0904007498 | VA | Primary |
Addresses
Primary practice location
5290 Shawnee Rd Ste 103
Alexandria, VA 22312-2381
Mailing address
440 Monticello Ave
Suite 1802 638348
Norfolk, VA 23510
Phone (202) 930-2770
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904007498 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709510400000",
"number": "1629379722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 MONTICELLO AVE",
"address_2": "SUITE 1802 638348",
"city": "NORFOLK",
"state": "VA",
"postal_code": "23510",
"telephone_number": "202-930-2770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5290 SHAWNEE RD STE 103",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223122381",
"telephone_number": "202-930-2770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "IHSAN",
"middle_name": "J",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-05",
"last_updated": "2024-03-04",
"certification_date": "2024-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904007498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.