Nurture Child and Family, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

904005796 Issued in VA

Legal business name

NURTURE CHILD AND FAMILY, PLLC

Practice address

1319 Vincent PL
MC Lean, VA 22101-3615

Phone

(703) 341-5995

Fax

(703) 341-5995

NPI assigned

Mar 17, 2016

Organization subpart

No

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

Authorized official

Name

Mark Steven Gardner, LCSWNPI 1073604112

Title

Member

Phone

(703) 341-5995

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Steven Gardner, LCSW

  • Clinical Social Worker
  • MC Lean, VA
  • NPI 1073604112
  NPD (past) Authorized official

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458172800000",
    "number": "1639530629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 VINCENT PL",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013615",
            "telephone_number": "703-341-5995",
            "fax_number": "703-341-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 VINCENT PL",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013615",
            "telephone_number": "703-341-5995",
            "fax_number": "703-341-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURTURE CHILD AND FAMILY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-17",
        "last_updated": "2016-03-17",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "703-341-5995",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VA",
            "license": "080003355",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "904005796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.