Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mary Taverner, LCSW

Individual provider Clinical Social Worker · NPI 1659046803

Mary Taverner, LCSW is a Clinical Social Worker in Fairfax, Virginia. Practices as a sole proprietor. Licensed in District of Columbia and Virginia.

Licensed in
DC, VA
In the registry since
2021
Specialties on file
2
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

3611 Chain Bridge Rd Ste C
Fairfax, VA 22030-3246
Phone: (703) 397-8163
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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 0904010991 (VA)
Clinical Social Worker Taxonomy 1041C0700X · Licence LC50081378 (DC)

Record details

NPI number1659046803
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedAugust 10, 2021
Last updated in NPPESAugust 10, 2021
Certification dateAugust 10, 2021

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