Individual provider Active NPI

Angelica N Bristor, LMSW

  • Social Worker
  • Hunt Valley, MD
National Provider Identifier
1104558485
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
26523 Issued in MD
Practice address
11350 McCormick Rd Ste 800
Hunt Valley, MD 21031-1002
Phone
(410) 800-2169
NPI assigned
Jun 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 26523 MD Primary

Addresses

Primary practice location

11350 McCormick Rd Ste 800
Hunt Valley, MD 21031-1002

Mailing address

2825 Benson Mill Rd
Sparks Glencoe, MD 21152-9575
Phone (443) 805-4823

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
26523MDMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1104558485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 BENSON MILL RD",
            "city": "SPARKS GLENCOE",
            "state": "MD",
            "postal_code": "211529575",
            "telephone_number": "443-805-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 MCCORMICK RD STE 800",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210311002",
            "telephone_number": "410-800-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTOR",
        "first_name": "ANGELICA",
        "middle_name": "N",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "26523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hunt Valley, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.