Paul Clifford Archibald, MA, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11283 Issued in MD

Practice address

1431 E Baltimore St
Baltimore, MD 21231-1405

Phone

(410) 342-4130

Fax

(410) 342-4130

NPI assigned

Jun 13, 2007

Last updated

May 12, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

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

• Archibald Optimal Health Services, LLC

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1306109343
  NPD Authorized official
• Archibald Optimal Health Services, LLC

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1518315944
  Authorized official Same address or phone
• ABA Health Services Counseling

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Baltimore, MD
  • NPI 1649593245
  NPD (past)
• ABA Health Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1720019672
  NPD (past)
• Dr. Jani Associates, LLC

  dba Community Behavioral Health

  • Community/Behavioral Health Agency
  • Cambridge, MD
  • NPI 1619171535
  NPD (past)

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1033313812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 E BALTIMORE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212311405",
            "telephone_number": "410-342-4130",
            "fax_number": "410-342-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 E BALTIMORE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212311405",
            "telephone_number": "410-342-4130",
            "fax_number": "410-342-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHIBALD",
        "first_name": "PAUL",
        "middle_name": "CLIFFORD",
        "name_prefix": "Dr.",
        "credential": "MA, LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "11283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008353400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Archers Lovely Hearts Home Care &Nrsa (Archers Lovely Hearts Home Care and NRSA LLC)
• Archers Lovely Hearts Home Care &Nrsa (Archers Lovely Hearts Home Care and NRSA LLC)
• Archers Lovely Hearts Home Care &Nrsa
• Archibald Optimal Health Services, LLC
• Archibald Optimal Health Services, LLC
• Jamie Archibong, M.A.
• Eyamba Archibong, LCSW-C
• Samantha Ann Archibong, CRNP-PMH
• Vivian Archibong, LCSW-C
• Kendarae Archie

• Clinical Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.