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Letethia Nathan

Individual provider Active NPI Clinical Social Worker · Joppa, MD

NPI 1033090402 · NPPES record last updated Sep 10, 2025

Key facts

NPI
1033090402
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
21391 (MD)
Practice address
626 Towne Center Dr Ste 204
Joppa, MD 21085-4451
Phone
(443) 313-3240
Fax
(301) 329-2025
NPI assigned
Sep 10, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
21391MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fresh Start Therapeutic Services, LLC Current
since Sep 14, 2025		 Accepting new patients

Locations

626 Towne Center Dr
Ste 204
Joppa, MD 21085
Phone (443) 313-3240

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 21391 MD Yes

Addresses

Primary practice location

626 Towne Center Dr Ste 204
Joppa, MD 21085-4451

Mailing address

626 Towne Center Dr Ste 204
Joppa, MD 21085-4451
Phone (443) 313-3240

Other providers in Joppa, MD

All providers in Joppa, MD · Clinical Social Worker in Maryland

Sources for this page

Verify at the official NPI Registry.