Active NPI
Christine Lederman, LCSW
- Social Worker
- Fairfax, VA
National Provider Identifier
1891794590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 0904001152
- Practice address
- 8500 Executive Park Ave
Suite 200
Fairfax, VA 22031-2225 - Phone
- (703) 698-5220
- Fax
- (703) 573-2351
- NPI assigned
- Jul 15, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 0904001152 | VA | Primary |
Addresses
Primary practice location
8500 Executive Park Ave
Suite 200
Fairfax, VA 22031-2225
Mailing address
8500 Executive Park Ave
Suite 200
Fairfax, VA 22031-2225
Phone (703) 698-5220
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 155712 | Other | VA | VALUEOPTIONS |
| 2160999 | Other | MAMSI | |
| 459944-000 | Other | VA | MAGELLAN |
| 513445 | Other | VA | NCPPO |
| 0064 | Other | VA | CAREFIRST NCA |
| 256978 | Other | VA | ANTHEM |
| 4634015 | Other | AETNA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0904001152 | VA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320883200000",
"number": "1891794590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8500 EXECUTIVE PARK AVE",
"address_2": "SUITE 200",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220312225",
"telephone_number": "703-698-5220",
"fax_number": "703-573-2351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8500 EXECUTIVE PARK AVE",
"address_2": "SUITE 200",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220312225",
"telephone_number": "703-698-5220",
"fax_number": "703-573-2351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEDERMAN",
"first_name": "CHRISTINE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-15",
"last_updated": "2011-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "VA",
"license": "0904001152",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUEOPTIONS",
"identifier": "155712",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "2160999",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "459944-000",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPPO",
"identifier": "513445",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST NCA",
"identifier": "0064",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "256978",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4634015",
"state": null
}
],
"endpoints": [],
"other_names": []
}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 Nov 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.