Individual provider Active NPI

Amy Jean Heilman, L.C.S.W.-C

  • Clinical Social Worker
  • Towson, MD
National Provider Identifier
1063790848
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11825 Issued in MD
Practice address
602 Providence Rd
Towson, MD 21286-5503
Phone
(410) 583-7443
NPI assigned
Jul 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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 11825 MD Primary

Addresses

Primary practice location

602 Providence Rd
Towson, MD 21286-5503

Mailing address

602 Providence Rd
Towson, MD 21286-5503
Phone (410) 583-7443

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150225000661 MD Practitioner - Clinical Social Worker 7012233794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2300 York Rd
Suite 104
Lutherville, MD 21093-2275
Phone (410) 245-9722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11825MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Outside the Lines Counseling LLC Clinical CurrentSince Sep 1, 2016 Accepting new patients

Locations

2300 York Rd
Ste 104
Lutherville Timonium, MD 21093
Phone (410) 245-9722

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311811200000",
    "number": "1063790848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 PROVIDENCE RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865503",
            "telephone_number": "410-583-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 PROVIDENCE RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865503",
            "telephone_number": "410-583-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEILMAN",
        "first_name": "AMY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-28",
        "last_updated": "2011-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "11825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.