Individual provider Active NPI

Janice Louise Fristad, LCSW, LGSW, CAE

  • Clinical Social Worker
  • Leesburg, VA
National Provider Identifier
1679817548
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904007920 Issued in VA
Practice address
2 Cardinal Park Dr SE Ste 104a
Leesburg, VA 20175-4448
Phone
(703) 980-9715
NPI assigned
Nov 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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 0904007920 VA Primary

Addresses

Primary practice location

2 Cardinal Park Dr SE Ste 104a
Leesburg, VA 20175-4448

Mailing address

1206 Musket CT NE
Leesburg, VA 20176-4805
Phone (703) 474-6202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20130327000333 VA Practitioner - Clinical Social Worker 0345485132 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2 Cardinal Park Dr SE
Suite 104a
Leesburg, VA 20175-4448
Phone (703) 474-6202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychotherapy Associates of Winchester Clinical CurrentSince Jul 13, 2018 Accepting new patients
Roxanne Ostlund LPC PLCC Past Accepting new patients

Locations

125 S Cameron St
Winchester, VA 22601
Phone (540) 722-0750

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1679817548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 MUSKET CT NE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764805",
            "telephone_number": "703-474-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CARDINAL PARK DR SE STE 104A",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201754448",
            "telephone_number": "703-980-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRISTAD",
        "first_name": "JANICE",
        "middle_name": "LOUISE",
        "credential": "LCSW, LGSW, CAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-16",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.