Individual provider Active NPI

Jamie Todd Metzler, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1093865974
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14659 Issued in MD
Practice address
5710 Newbury St
2ND Floor
Baltimore, MD 21209-3657
Phone
(443) 501-4094
Fax
(443) 501-4094
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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 14659 MD Primary

Addresses

Primary practice location

5710 Newbury St
2ND Floor
Baltimore, MD 21209-3657

Mailing address

1435 Boyle St
Baltimore, MD 21230-5112
Phone (443) 468-8834

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
I20091019000525 MD Practitioner - Clinical Social Worker 4587606512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1707 Rosemont Ave
Frederick, MD 21702-4135
Phone (410) 262-4128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14659MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Counseling LLC Clinical CurrentSince Jun 7, 2011 Accepting new patients

Locations

5710 Newbury St
Ste 2
Baltimore, MD 21209
Phone (301) 351-3509

198 Thomas Johnson Dr
Ste 9
Frederick, MD 21702
Phone (301) 639-1545

1707 Rosemont Ave
Frederick, MD 21702
Phone (240) 347-2581

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1093865974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 BOYLE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212305112",
            "telephone_number": "443-468-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 NEWBURY ST",
            "address_2": "2ND FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093657",
            "telephone_number": "443-501-4094",
            "fax_number": "443-501-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZLER",
        "first_name": "JAMIE",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2011-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.