Individual provider Active NPI

Stephanie Brown

  • Clinical Social Worker
  • Fairfax, VA
National Provider Identifier
1750737631
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904009378 Issued in VA
Practice address
3611 Chain Bridge Rd
Suite C
Fairfax, VA 22030-3246
Phone
(703) 380-9045
NPI assigned
May 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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 0904009378 VA Primary

Addresses

Primary practice location

3611 Chain Bridge Rd
Suite C
Fairfax, VA 22030-3246

Mailing address

3611 Chain Bridge Rd
Suite C
Fairfax, VA 22030-3246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904009378VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1750737631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 CHAIN BRIDGE RD",
            "address_2": "SUITE C",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 CHAIN BRIDGE RD",
            "address_2": "SUITE C",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303246",
            "telephone_number": "703-380-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.