Penny Sue Walters, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12725 Issued in MD

Practice address

26916 Siloam Rd
Salisbury, MD 21801-1292

Phone

(410) 603-2807

NPI assigned

Aug 22, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evolve Mental WellnessGroup PAC ID 6608266846, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Evolve Mental Wellness

  • Mental Health Counselor
  • Salisbury, MD
  • NPI 1912597857

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1629590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629590400000",
    "number": "1053087775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26916 SILOAM RD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218011292",
            "telephone_number": "410-603-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26916 SILOAM RD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218011292",
            "telephone_number": "410-603-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "PENNY",
        "middle_name": "SUE",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-22",
        "last_updated": "2021-08-22",
        "certification_date": "2021-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy D Walsh, M.D.
• Mark David Walsh, M.D.
• Walter C Schaefer MD PA
• Jessica Marie Walter, PHD, ATC
• Joseph George Walters, PAC
• Wendy Marie Walters, OT
• Tai Chuan Wang
• Margaret Mumbi Wangombe
• Benjamin J Waples, ATC
• Jacqueline Leigh Ward-Baker, LCPC

• Clinical Social Worker in Salisbury, MD
• Providers in Salisbury, 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 Aug 22, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.