Individual provider Active NPI

Alexandra Johnson, LCSW

  • Clinical Social Worker
  • Chantilly, VA
National Provider Identifier
1831977529
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904015452 Issued in VA
Practice address
14150 Parkeast Cir Ste 200
Chantilly, VA 20151-4212
Phone
(703) 968-4000
NPI assigned
Sep 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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 0904015452 VA Primary

Addresses

Primary practice location

14150 Parkeast Cir Ste 200
Chantilly, VA 20151-4212

Mailing address

14150 Parkeast Cir Ste 200
Chantilly, VA 20151-4212

Other practice location 1

2340 Commonwealth Dr Ste 101
Charlottesville, VA 22901-1634
Phone (732) 451-3895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20241205001476 DC Practitioner - Clinical Social Worker 9032645791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Director of Finance-County of Fairfax VAGroup PAC ID 9739136847, 176 clinicians

Practice addresses (Care Compare)

14150 Parkeast Cir
Suite 200
Chantilly, VA 20151-4212
Phone (703) 324-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904015452VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebulb LLC CurrentSince Sep 1, 2023 Accepting new patients
Fairfax County, Virginia CurrentSince Nov 26, 2024 Accepting new patients

Locations

505 Main St
Toms River, NJ 08753
Phone (732) 272-0127

6210 Old Franconia Rd
#A
Alexandria, VA 22310
Phone (703) 955-3703

2340 Commonwealth Dr
Ste 101
Charlottesville, VA 22901
Phone (732) 451-3895

14150 Parkeast Cir
Ste 200
Fairfax, VA 20151
Phone (703) 449-6114

12011 Government Center Pkwy
Ste 836
Fairfax, VA 22035
Phone (703) 324-7017

Organizations & group practices 2

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": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1831977529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14150 PARKEAST CIR STE 200",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201514212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14150 PARKEAST CIR STE 200",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201514212",
            "telephone_number": "703-968-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2340 Commonwealth Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229011634",
            "country_code": "US",
            "telephone_number": "732-451-3895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALEXANDRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904015452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

Verify at the official NPI Registry.