Individual provider Active NPI

Kimberly M Maxwell

  • Social Worker
  • Bel Air, MD
National Provider Identifier
1104394584
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
112 W Pennsylvania Ave Ste 100
Bel Air, MD 21014-3663
Phone
(443) 787-2538
NPI assigned
Nov 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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 23158 MD
Social Worker 104100000X Primary

Addresses

Primary practice location

112 W Pennsylvania Ave Ste 100
Bel Air, MD 21014-3663

Mailing address

112 W Pennsylvania Ave Ste 100
Bel Air, MD 21014-3663
Phone (443) 787-2538

Other practice location 1

112 Oak Moore Ct
Bel Air, MD 21014-2731
Phone (443) 787-2538

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
I20220207000708 MD Practitioner - Clinical Social Worker 1254724792 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Bel Air, MD 21014
Phone (443) 787-2538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23158MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Catholic Charities, Inc. Current Accepting new patients
Associated Catholic Charities, Inc CurrentSince Jan 1, 2022 Accepting new patients
Piece of Mind Behavioral Therapy CurrentSince Nov 7, 2024 Accepting new patients
Associated Catholic Charities, Inc. CurrentSince Jan 1, 2022 Accepting new patients

Locations

1301 Continental Dr
Ste 101
Abingdon, MD 21009
Phone (667) 600-3217

112 W Pennsylvania Ave
Ste 100
Bel Air, MD 21014
Phone (410) 987-1036

2700 Washington Ave
Lansdowne, MD 21227
Phone (667) 600-3984

2300 Dulaney Valley Rd
Ste B
Timonium, MD 21093

Organizations & group practices 4

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": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1104394584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 W PENNSYLVANIA AVE STE 100",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210143663",
            "telephone_number": "443-787-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W PENNSYLVANIA AVE STE 100",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210143663",
            "telephone_number": "443-787-2538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Oak Moore Ct",
            "address_purpose": "LOCATION",
            "city": "Bel Air",
            "state": "MD",
            "postal_code": "210142731",
            "country_code": "US",
            "telephone_number": "443-787-2538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-05",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "23158",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.