Individual provider Active NPI

Mamata Hotha, LGSW, LSW

  • Clinical Social Worker
  • Rockville, MD
National Provider Identifier
1053798470
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20109 Issued in MD
Practice address
15701 Crabbs Branch Way
Rockville, MD 20855-2634
Phone
(917) 574-1240
Fax
(301) 365-2590
NPI assigned
May 5, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 20109 MD Primary

Addresses

Primary practice location

15701 Crabbs Branch Way
Rockville, MD 20855-2634

Mailing address

15701 Crabbs Branch Way
Rockville, MD 20855-2634
Phone (917) 574-1240

Other practice location 1

4445 Willard Ave
Chevy Chase, MD 20815-3690
Phone (323) 205-7088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20210728002883 DC Practitioner - Clinical Social Worker 4688077670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willow Oak Therapy Center, IncGroup PAC ID 5698661023, 18 clinicians

Practice addresses (Care Compare)

15701 Crabbs Branch Way
Rockville, MD 20855-2634
Phone (301) 251-8965

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20109MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Oak Therapy Center, Inc. CurrentSince Jul 14, 2021 Accepting new patients
Jody Tabner Thayer LLC Clinical PastSince Feb 23, 2020 Accepting new patients

Locations

15701 Crabbs Branch Way
Rockville, MD 20855
Phone (301) 251-8965

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1053798470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15701 CRABBS BRANCH WAY",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208552634",
            "telephone_number": "917-574-1240",
            "fax_number": "301-365-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15701 CRABBS BRANCH WAY",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208552634",
            "telephone_number": "917-574-1240",
            "fax_number": "301-365-2590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4445 Willard Ave",
            "address_purpose": "LOCATION",
            "city": "Chevy Chase",
            "state": "MD",
            "postal_code": "208153690",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOTHA",
        "first_name": "MAMATA",
        "credential": "LGSW, LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-05",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "20109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.