Individual provider Active NPI

Carley Kelcee Agueda-Divens, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1073225397
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25887 Issued in MD
Practice address
130 N Bradford St
Baltimore, MD 21224-1036
Phone
(443) 540-8280
NPI assigned
Dec 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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 25887 MD Primary

Addresses

Primary practice location

130 N Bradford St
Baltimore, MD 21224-1036

Mailing address

130 N Bradford St
Baltimore, MD 21224-1036
Phone (443) 540-8280

Medicare participation

Medicare enrollment files
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.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
70.75 of 100Reported as group
Quality
42.65
Promoting interoperability
51
Improvement activities
40
Cost
84.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Medical Center, LLC PastSince Feb 18, 2024 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1073225397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N BRADFORD ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212241036",
            "telephone_number": "443-540-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N BRADFORD ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212241036",
            "telephone_number": "443-540-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUEDA-DIVENS",
        "first_name": "CARLEY",
        "middle_name": "KELCEE",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "25887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.