Active NPI
Nicole Fetter, MSW, LISW
- Social Worker
- Fort George G Meade, MD
National Provider Identifier
1083032791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- I 1302782
- Practice address
- 2480 Llewellyn Ave
Fort George G Meade, MD 20755-7081 - Phone
- (301) 677-8582
- NPI assigned
- Mar 31, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | I 1302782 | OH | Primary |
Addresses
Primary practice location
2480 Llewellyn Ave
Fort George G Meade, MD 20755-7081
Mailing address
2480 Llewellyn Ave
Fort George G Meade, MD 20755-7081
Phone (301) 677-8582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I 1302782 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757030400000",
"number": "1083032791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2480 LLEWELLYN AVE",
"city": "FORT GEORGE G MEADE",
"state": "MD",
"postal_code": "207557081",
"telephone_number": "301-677-8582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2480 LLEWELLYN AVE",
"city": "FORT GEORGE G MEADE",
"state": "MD",
"postal_code": "207557081",
"telephone_number": "301-677-8582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FETTER",
"first_name": "NICOLE",
"credential": "MSW, LISW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-31",
"last_updated": "2025-09-05",
"certification_date": "2025-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "I 1302782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort George G Meade, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.