Individual provider Active NPI

Eileen Michelle Flores, LCSW

  • Clinical Social Worker
  • Fairfax, VA
National Provider Identifier
1780861716
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904018561 Issued in VA
Practice address
11204 Waples Mill Rd
Fairfax, VA 22030-6036
Phone
(703) 218-8500
Fax
(703) 359-0463
NPI assigned
Jan 22, 2008
Last updated
Oct 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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 0904018561 VA Primary

Addresses

Primary practice location

11204 Waples Mill Rd
Fairfax, VA 22030-6036

Mailing address

11204 Waples Mill Rd
Fairfax, VA 22030-6036
Phone (703) 218-8500

Other practice location 1

11200 Waples Mill Rd Ste 180
Fairfax, VA 22030-7407
Phone (703) 218-8500

Other practice location 2

46050 Manekin Plz Ste 110
Sterling, VA 20166-6519
Phone (703) 218-8500

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
0904018561VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lolly Therapeutics, LLC Clinical PastSince Mar 5, 2023 Accepting new patients
Inova Kellar Center Past Accepting new patients
Integrative Therapy Concepts PastSince Mar 5, 2023 Accepting new patients
Inova Health Care Services Past Accepting new patients

Organizations & group practices 4

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": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1780861716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11204 WAPLES MILL RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306036",
            "telephone_number": "703-218-8500",
            "fax_number": "703-359-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11204 WAPLES MILL RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306036",
            "telephone_number": "703-218-8500",
            "fax_number": "703-359-0463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11200 Waples Mill Rd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220307407",
            "country_code": "US",
            "telephone_number": "703-218-8500",
            "fax_number": "703-359-0463",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "46050 Manekin Plz Ste 110",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201666519",
            "country_code": "US",
            "telephone_number": "703-218-8500",
            "fax_number": "703-359-0463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLORES",
        "first_name": "EILEEN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904018561",
            "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 Oct 22, 2025; 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.