Individual provider Active NPI

Judith Helene Ratliff, LCSW MSW

  • Clinical Social Worker
  • Fairfax, VA
National Provider Identifier
1811095367
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904001428 Issued in VA
Practice address
3700 Joseph Siewick Drive
Suite 402
Fairfax, VA 22033
Phone
(703) 758-1660
Fax
(703) 758-1660
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0904001428 VA Primary

Addresses

Primary practice location

3700 Joseph Siewick Drive
Suite 402
Fairfax, VA 22033

Mailing address

2155 Golf Course Drive
Reston, VA 20191-3834
Phone (703) 758-1660

Other names 1

  • Miss Judith Helene Fine Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904001428VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811095367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 GOLF COURSE DRIVE",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913834",
            "telephone_number": "703-758-1660",
            "fax_number": "703-716-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DRIVE",
            "address_2": "SUITE 402",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22033",
            "telephone_number": "703-758-1660",
            "fax_number": "703-758-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATLIFF",
        "first_name": "JUDITH",
        "middle_name": "HELENE",
        "name_prefix": "Ms.",
        "credential": "LCSW MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904001428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "FINE",
            "middle_name": "HELENE",
            "prefix": "MISS",
            "credential": "MSW LCSWC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jul 8, 2007; 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.