Individual provider Active NPI

June Bobrin Wynn, LCSW

  • Clinical Social Worker
  • Dumfries, VA
National Provider Identifier
1861411803
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904001455 Issued in VA
Practice address
17606 Main St
Suite 204
Dumfries, VA 22026-2343
Phone
(703) 221-1481
NPI assigned
Jul 19, 2006
Last updated
May 12, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2008

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 0904001455 VA Primary

Addresses

Primary practice location

17606 Main St
Suite 204
Dumfries, VA 22026-2343

Mailing address

17606 Main St
Suite 204
Dumfries, VA 22026-2343
Phone (703) 221-1481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090107000607 VA Practitioner - Clinical Social Worker 2769545334 Practice locations: Dumfries, VA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4597 Clearwater CT
Dumfries, VA 22025-1422
Phone (703) 855-4694

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904001455VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1861411803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17606 MAIN ST",
            "address_2": "SUITE 204",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220262343",
            "telephone_number": "703-221-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17606 MAIN ST",
            "address_2": "SUITE 204",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220262343",
            "telephone_number": "703-221-1481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "JUNE",
        "middle_name": "BOBRIN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904001455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dumfries, VA

Sources for this page

Verify at the official NPI Registry.