Jacqueline Leigh Tyler, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904005809 Issued in VA

Practice address

2504 Patrick St
Vienna, VA 22180-6844

Phone

(703) 207-9136

Fax

(703) 207-9740

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871600635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 N DEARING ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021807",
            "telephone_number": "703-820-7239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 PATRICK ST",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221806844",
            "telephone_number": "703-207-9136",
            "fax_number": "703-207-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "JACQUELINE",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trinity Hospice of Virginia, LLC
• True Wellness Center, LLC
• Demet D Tunc, O.D.
• Turning Leaf Counseling Services LLC
• Sallie Twentyman, MSW, LCSW
• Tazhae Tyler
• Olivia Tyra
• Tyson Orthodontics, PC
• Tyson Urgent Care, LLC
• David Sheldon Tyson, LCSW, LCSW-C, LICSW

• Clinical Social Worker in Vienna, VA
• Providers in Vienna, VA by specialty
• Clinical Social Worker in Virginia

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.