Naomi Phyllis Bartakke, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904001922 Issued in VA

Practice address

11250 Roger Bacon Dr
Suite 6
Reston, VA 20190-5219

Phone

(571) 250-6978

Fax

(877) 334-0608

NPI assigned

Nov 15, 2012

Last updated

Nov 15, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1871837781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11250 ROGER BACON DR",
            "address_2": "SUITE 6",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905219",
            "telephone_number": "571-250-6978",
            "fax_number": "877-334-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11250 ROGER BACON DR",
            "address_2": "SUITE 6",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905219",
            "telephone_number": "571-250-6978",
            "fax_number": "877-334-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTAKKE",
        "first_name": "NAOMI",
        "middle_name": "PHYLLIS",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904001922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiara Anese Barnett
• Marianne Barnhill, M.D.
• Anisa Abdi Barre
• Danya Maria Barrera
• Pamela Dawn Barstow, FNP-BC
• Ticoni Antoine Barte, D.O.
• Nicholas Batchelor
• Nicole Juliette Battle, MD
• Matthew Thomas Battles, PA-C
• Bayasi Surgical Associates PLLC

• Clinical Social Worker in Reston, VA
• Providers in Reston, 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 Nov 15, 2012; 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.