Tracy Joan Ryan Kidd, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904001855 Issued in VA

Practice address

410 Maple Ave W Ste 7
Vienna, VA 22180-4224

Phone

(703) 281-9313

Fax

(703) 281-9769

NPI assigned

Jan 5, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Virginia Family Counseling, Inc.

  • Community/Behavioral Health Agency
  • Vienna, VA
  • NPI 1316276603
  NPD (past)

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1720318231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 MAPLE AVE W STE 7",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804224",
            "telephone_number": "703-281-9313",
            "fax_number": "703-281-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MAPLE AVE W STE 7",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804224",
            "telephone_number": "703-281-9313",
            "fax_number": "703-281-9769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN KIDD",
        "first_name": "TRACY",
        "middle_name": "JOAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-05",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904001855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Ruiz, LCMHC, LPC, NCC
• Chaniece Rumph, PMHNP
• Paul G Rupp, ATC
• Rxwellness Spine & Health - Tysons McLean LLC
• Rxwellness Spine & Health - Vienna LLC
• Susanna Ryan, RN
• James Kiyoung Ryee, DDS
• S. Weldon Brown, DDS, LTD
• Ahmed K Saad, D.D.S.
• Amer A Saba, M.D.

• Clinical Social Worker in Vienna, VA
• Providers in Vienna, 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 Jan 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.