Active NPI
Kristilee P Sheffler, LGSW
- Clinical Social Worker
- Glen Burnie, MD
National Provider Identifier
1083967004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 18481
- Practice address
- 804 Landmark Dr
Suite 118
Glen Burnie, MD 21061-4486 - Phone
- (410) 863-7213
- Fax
- (410) 863-7205
- NPI assigned
- Oct 16, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 18481 | MD | Primary |
Addresses
Primary practice location
804 Landmark Dr
Suite 118
Glen Burnie, MD 21061-4486
Mailing address
804 Landmark Dr
Suite 118
Glen Burnie, MD 21061-4486
Phone (410) 863-7213
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 |
|---|---|---|---|
| 18481 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindful Ways LLC | Clinical | Current | 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.
-
- Clinical Social Worker
- Severn, MD
- NPI 1477127967
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350345600000",
"number": "1083967004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 LANDMARK DR",
"address_2": "SUITE 118",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210614486",
"telephone_number": "410-863-7213",
"fax_number": "410-863-7205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 LANDMARK DR",
"address_2": "SUITE 118",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210614486",
"telephone_number": "410-863-7213",
"fax_number": "410-863-7205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEFFLER",
"first_name": "KRISTILEE",
"middle_name": "P",
"credential": "LGSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-16",
"last_updated": "2012-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "18481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Burnie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.