Active NPI
Mary Brenneman, LCSW-C
- Social Worker
- Baltimore, MD
National Provider Identifier
1023041191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 04998
- Practice address
- 7827 Wise Ave
Baltimore, MD 21222-3339 - Phone
- (410) 282-7222
- Fax
- (410) 282-0069
- NPI assigned
- Jul 9, 2006
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 04998 | MD | Primary |
Addresses
Primary practice location
7827 Wise Ave
Baltimore, MD 21222-3339
Mailing address
7827 Wise Ave
Baltimore, MD 21222-3339
Phone (410) 282-7222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04998 | MD | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192060800000",
"number": "1023041191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7827 WISE AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212223339",
"telephone_number": "410-282-7222",
"fax_number": "410-282-0069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7827 WISE AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212223339",
"telephone_number": "410-282-7222",
"fax_number": "410-282-0069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNEMAN",
"first_name": "MARY",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-09",
"last_updated": "2007-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "04998",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.