Provider Demographics
NPI:1477954337
Name:HEWITT, JEFFREY BARTLESON (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:BARTLESON
Last Name:HEWITT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3454 S UTAH ST APT B1
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-1942
Mailing Address - Country:US
Mailing Address - Phone:703-303-7027
Mailing Address - Fax:
Practice Address - Street 1:8500 EXECUTIVE PARK AVE STE 204
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2253
Practice Address - Country:US
Practice Address - Phone:703-876-8480
Practice Address - Fax:703-876-8482
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040056871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical