Sheila L Bryant, LCSW-C – Clinical Social Worker

Key facts

NPI: 1104158716
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: 15546 (MD)
Practice address: 604 Shirley Manor Rd
Reisterstown, MD 21136-2319
Phone: (443) 255-5408
NPI assigned: Feb 6, 2010
Sex: Female
Sole proprietor: Yes

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.

Simply Living Blessed, LLC Mental Health Counselor · Owings Mills, MD · NPI 1386025161

NPD Authorized official CLINICAL

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
Simply Living Blessed, LLC	Clinical	Current	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	15546	MD	Yes

Addresses

Primary practice location

604 Shirley Manor Rd
Reisterstown, MD 21136-2319

Mailing address

604 Shirley Manor Rd
Reisterstown, MD 21136-2319
Phone (443) 255-5408

Other identifiers

Identifier	Type	State	Issuer
419159500	Medicaid	MD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 25, 2019.

{
    "created_epoch": "1265414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1104158716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 SHIRLEY MANOR RD",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211362319",
            "telephone_number": "443-255-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 SHIRLEY MANOR RD",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211362319",
            "telephone_number": "443-255-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "SHEILA",
        "middle_name": "L",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-06",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419159500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Reisterstown, MD · Clinical Social Worker in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.