Individual provider Active NPI

Corey Thornton, LCSW

  • Clinical Social Worker
  • Annandale, VA
National Provider Identifier
1639469166
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904007477 Issued in VA
Practice address
3340 Woodburn Rd
Annandale, VA 22003-1202
Phone
(703) 207-7821
NPI assigned
Apr 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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 0904007477 VA Primary

Addresses

Primary practice location

3340 Woodburn Rd
Annandale, VA 22003-1202

Mailing address

3340 Woodburn Rd
Annandale, VA 22003-1202
Phone (703) 207-7821

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
I20110616000501 DC Practitioner - Clinical Social Worker 8527246727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8221 Willow Oaks Corporate Dr
Fairfax Falls Church Community Services Boa
Fairfax, VA 22031-4512
Phone (703) 321-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1639469166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 WOODBURN RD",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220031202",
            "telephone_number": "703-207-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 WOODBURN RD",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220031202",
            "telephone_number": "703-207-7821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "COREY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-18",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

Verify at the official NPI Registry.