Individual provider Active NPI

Esther Birch Widra, LCPC

  • Counselor
  • Berlin, MD
National Provider Identifier
1093896052
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LC1184 Issued in NU
Practice address
9730 Healthway Dr
Berlin, MD 21811-1154
Phone
(410) 629-0164
NPI assigned
Oct 18, 2006
Last updated
Apr 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LC1184 NU Primary

Addresses

Primary practice location

9730 Healthway Dr
Berlin, MD 21811-1154

Mailing address

9730 Healthway Dr
Berlin, MD 21811-1154
Phone (410) 251-1199

Other identifiers 1

IdentifierTypeStateIssuer
1093896052MedicaidMD

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
I20240606004212 MD Practitioner - Mental Health Counselor 4880136704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9730 Healthway Dr
Berlin, MD 21811-1154
Phone (410) 629-0164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Worcester County Health Department Current Accepting new patients
Worcester County Health Department CurrentSince Apr 23, 2024 Accepting new patients
Worcester County Health Department CurrentSince Apr 23, 2024 Accepting new patients

Locations

9730 Healthway Dr
Berlin, MD 21811
Phone (410) 629-0164

6040 Public Landing Rd
Snow Hill, MD 21863
Phone (410) 629-0041

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1093896052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9730 HEALTHWAY DR",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111154",
            "telephone_number": "410-251-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 HEALTHWAY DR",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111154",
            "telephone_number": "410-629-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDRA",
        "first_name": "ESTHER",
        "middle_name": "BIRCH",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": "LC1184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093896052",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

Verify at the official NPI Registry.