Active NPI
Antonio Hedgepeth
- Clinical Social Worker
- Laurel, MD
National Provider Identifier
1003795113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 36676
- Practice address
- 14440 Cherry Lane CT Ste 208
Laurel, MD 20707-4946 - Phone
- (301) 604-1458
- Fax
- (301) 604-1459
- NPI assigned
- Sep 2, 2025
- Sex
- Male
- 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 | 36676 | MD | Primary |
Addresses
Primary practice location
14440 Cherry Lane CT Ste 208
Laurel, MD 20707-4946
Mailing address
10202 Twisted Stalk CT
Upper Marlboro, MD 20772-4526
Phone (202) 422-7096
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36676 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756771200000",
"number": "1003795113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10202 TWISTED STALK CT",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207724526",
"telephone_number": "202-422-7096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14440 CHERRY LANE CT STE 208",
"city": "LAUREL",
"state": "MD",
"postal_code": "207074946",
"telephone_number": "301-604-1458",
"fax_number": "301-604-1459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEDGEPETH",
"first_name": "ANTONIO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-09-02",
"last_updated": "2025-09-02",
"certification_date": "2025-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "36676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.