Individual provider Active NPI

Jerome Anderson, DSW, LCSW, BCD, CCFC

  • Clinical Social Worker
  • Bethesda, MD
National Provider Identifier
1023435807
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC200001949 Issued in DC
Practice address
Walter Reed National Medical Center
8901 Wisconsin Avenue
Bethesda, MD 20889
Phone
(202) 699-1860
NPI assigned
Mar 18, 2014
Last updated
Aug 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2011009028 MO
Clinical Social Worker 1041C0700X LC200001949 DC Primary

Addresses

Primary practice location

Walter Reed National Medical Center
8901 Wisconsin Avenue
Bethesda, MD 20889

Mailing address

22505 Gateway Center Dr
PO Box 1001
Clarksburg, MD 20871-1001
Phone (314) 651-4014

Other practice location 1

13106 Clarksburg Square Rd
Clarksburg, MD 20871-4514
Phone (314) 651-4014

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC200001949DCMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1023435807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22505 GATEWAY CENTER DR",
            "address_2": "PO BOX 1001",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208711001",
            "telephone_number": "314-651-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WALTER REED NATIONAL MEDICAL CENTER",
            "address_2": "8901 WISCONSIN AVENUE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20889",
            "telephone_number": "202-699-1860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13106 Clarksburg Square Rd",
            "address_purpose": "LOCATION",
            "city": "Clarksburg",
            "state": "MD",
            "postal_code": "208714514",
            "country_code": "US",
            "telephone_number": "314-651-4014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "DSW, LCSW, BCD, CCFC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-18",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2011009028",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200001949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.

Verify at the official NPI Registry.