Individual provider Active NPI

Ladonna Tyrina Winnegan, LCSW-C

  • Clinical Social Worker
  • College Park, MD
National Provider Identifier
1083398762
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
31511 Issued in MD
Practice address
4912 Nantucket Rd
College Park, MD 20740-1458
Phone
(703) 429-0157
NPI assigned
Jun 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 31511 MD Primary
Social Worker 104100000X LG200002444 DC

Addresses

Primary practice location

4912 Nantucket Rd
College Park, MD 20740-1458

Mailing address

4912 Nantucket Rd
College Park, MD 20740-1458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20251003003860 MD Practitioner - Clinical Social Worker 6709382039 Reassigns benefits to 1 organization
I20251006002942 DC Practitioner - Clinical Social Worker 6709382039 Reassigns benefits to 1 organization
Practice locations: Reston, VA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2025 Fulton PL
Apt 511
Reston, VA 20191-1187

2025 Fulton PL
Apt 511
Reston, VA 20191-5621
Phone (804) 236-6986

500 Westover Dr
Sanford, NC 27330-8941

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LG200002444DCMDSocial Worker
31511MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Sep 4, 2025 Accepting new patients
Mental Health Specialty Group PA CurrentSince Sep 19, 2025 Accepting new patients

Locations

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

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": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1083398762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912 NANTUCKET RD",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207401458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4912 NANTUCKET RD",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207401458",
            "telephone_number": "703-429-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINNEGAN",
        "first_name": "LADONNA",
        "middle_name": "TYRINA",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "31511",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "DC",
            "license": "LG200002444",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Park, MD

Sources for this page

Verify at the official NPI Registry.