Individual provider Active NPI

Darrell Coleman, LCSW-C

  • Clinical Social Worker
  • District Heights, MD
National Provider Identifier
1083989370
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19378 Issued in MD
Practice address
3900 Penn Belt PL
District Heights, MD 20747-4734
Phone
(301) 276-5312
NPI assigned
Mar 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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 P006630 NC
Clinical Social Worker 1041C0700X 19378 MD Primary

Addresses

Primary practice location

3900 Penn Belt PL
District Heights, MD 20747-4734

Mailing address

3900 Penn Belt PL
District Heights, MD 20747-4734
Phone (301) 276-5312

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

LicenseStateTypeSpecialty
19378MDMDClinical Social Worker
P006630NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Elevation & Enrichment Therapeutic Services Clinical Current Accepting new patients
Elevation & Enrichment Therapeutic Services Clinical CurrentSince Sep 23, 2021 Accepting new patients
Essentials to Wellness Current Accepting new patients

Locations

6201 Greenbelt Rd
Ste U4
Berwyn Heights, MD 20740
Phone (240) 354-8552

3900 Penn Belt Pl
District Heights, MD 20747
Phone (301) 276-5312

Organizations & group practices 3

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": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1083989370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 PENN BELT PL",
            "city": "DISTRICT HEIGHTS",
            "state": "MD",
            "postal_code": "207474734",
            "telephone_number": "301-276-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 PENN BELT PL",
            "city": "DISTRICT HEIGHTS",
            "state": "MD",
            "postal_code": "207474734",
            "telephone_number": "301-276-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "DARRELL",
        "name_prefix": "Mr.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-20",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P006630",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "19378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in District Heights, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.