Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lisa Jackson-Wardlaw, LCSW

Individual provider Clinical Social Worker · NPI 1427404599

Lisa Jackson-Wardlaw, LCSW is a Clinical Social Worker in Chantilly, Virginia. Practices as a sole proprietor. Licensed in Louisiana, Oregon and Virginia.

Licensed in
LA, OR, VA
In the registry since
2016
Specialties on file
3
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

13503 Lee Jackson Memorial Hwy
Chantilly, VA 20151-3401
Phone: (571) 730-7743
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 0904010532 (VA)
Clinical Social Worker Taxonomy 1041C0700X · Licence 17963 (LA)
Clinical Social Worker Taxonomy 1041C0700X · Licence L14171 (OR)

Record details

NPI number1427404599
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMay 9, 2016
Last updated in NPPESJuly 21, 2023
Certification dateJuly 21, 2023

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