Active NPI
Gloria Jean Mog, LCSW
- Clinical Social Worker
- Falls Church, VA
National Provider Identifier
1992825962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0511
- Practice address
- 6073 Arlington Blvd
Falls Church, VA 22044-2721 - Phone
- (703) 550-4164
- Fax
- (703) 237-9197
- NPI assigned
- Mar 31, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0511 | VA | Primary |
Addresses
Primary practice location
6073 Arlington Blvd
Falls Church, VA 22044-2721
Mailing address
6073 Arlington Blvd
Falls Church, VA 22044-2721
Phone (703) 550-4164
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2013 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0511 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992825962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6073 ARLINGTON BLVD",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220442721",
"telephone_number": "703-550-4164",
"fax_number": "703-237-9197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6073 ARLINGTON BLVD",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220442721",
"telephone_number": "703-550-4164",
"fax_number": "703-237-9197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOG",
"first_name": "GLORIA",
"middle_name": "JEAN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Falls Church, VA
Sources for this page
- 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.