Individual provider Active NPI

Alexis Maria Peacock, LMSW

  • Clinical Social Worker
  • Hagerstown, MD
National Provider Identifier
1083386130
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
124 E Baltimore St
Hagerstown, MD 21740-6104
Phone
(240) 500-0481
NPI assigned
Sep 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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 Primary

Addresses

Primary practice location

124 E Baltimore St
Hagerstown, MD 21740-6104

Mailing address

810 Mulberry Ave
Hagerstown, MD 21742-3957
Phone (240) 500-0481

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
I20250430000535 MD Practitioner - Clinical Social Worker 8527584838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wells House IncGroup PAC ID 8022545714, 5 clinicians

Practice addresses (Care Compare)

124 E Baltimore St
Hagerstown, MD 21740-6104
Phone (301) 739-7748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wells House Inc CurrentSince Apr 1, 2025 Accepting new patients
Wells House Inc Past Accepting new patients

Locations

330 Frederick St
Hagerstown, MD 21740
Phone (240) 203-8864

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": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1083386130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 MULBERRY AVE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217423957",
            "telephone_number": "240-500-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E BALTIMORE ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406104",
            "telephone_number": "240-500-0481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "ALEXIS",
        "middle_name": "MARIA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.