Individual provider Active NPI

Mary Iadarola, LCSW

  • Social Worker
  • Fairfax, VA
National Provider Identifier
1669865523
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
0904008879 Issued in VA
Practice address
3025 Hamaker CT Ste 450
Fairfax, VA 22031-2237
Phone
(240) 800-5772
NPI assigned
Mar 16, 2015
Last updated
Feb 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 0904008879 VA Primary
Clinical Social Worker 1041C0700X 06664 MD

Addresses

Primary practice location

3025 Hamaker CT Ste 450
Fairfax, VA 22031-2237

Mailing address

200 Wood Hill Rd
Rockville, MD 20850-8724
Phone (703) 204-9100

Other practice location 1

200 Wood Hill Rd
Rockville, MD 20850-8724
Phone (240) 800-5772

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
I20150515000054 DC Practitioner - Clinical Social Worker 0345560397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jewish Social Service AgencyGroup PAC ID 8123920097, 22 clinicians

Practice addresses (Care Compare)

3025 Hamaker CT
Suite 450
Fairfax, VA 22031-2237
Phone (703) 204-9100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904008879VAMDSocial Worker
06664MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Social Service Agency Social Worker CurrentSince Mar 30, 2015 Accepting new patients
Jewish Social Service Agency CurrentSince Mar 30, 2015 Accepting new patients
Jewish Social Service Agency Social Worker Current Accepting new patients

Locations

200 Wood Hill Rd
Rockville, MD 20850
Phone (240) 800-5772

6123 Montrose Rd
Rockville, MD 20852
Phone (301) 838-4200

3018 Javier Rd
Fairfax, VA 22031
Phone (703) 204-9100

3025 Hamaker Ct
Ste 450
Fairfax, VA 22031
Phone (240) 800-5772

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1669865523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WOOD HILL RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208508724",
            "telephone_number": "703-204-9100",
            "fax_number": "301-610-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 HAMAKER CT STE 450",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312237",
            "telephone_number": "240-800-5772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Wood Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208508724",
            "country_code": "US",
            "telephone_number": "240-800-5772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IADAROLA",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VA",
            "license": "0904008879",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "06664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.