Active NPI
Brandi Daugherty, LCSW-C
- Clinical Social Worker
- Baltimore, MD
National Provider Identifier
1124462718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 14260
- Practice address
- 11550 Crossroads Cir
Unit 450
Baltimore, MD 21220-2946 - Phone
- (717) 487-2573
- NPI assigned
- Apr 25, 2013
- Last updated
- Apr 25, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 14260 | MD | Primary |
Addresses
Primary practice location
11550 Crossroads Cir
Unit 450
Baltimore, MD 21220-2946
Mailing address
11550 Crossroads Cir
Unit 450
Baltimore, MD 21220-2946
Phone (717) 487-2573
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14260 | MD | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366848000000",
"number": "1124462718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11550 CROSSROADS CIR",
"address_2": "UNIT 450",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212202946",
"telephone_number": "717-487-2573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11550 CROSSROADS CIR",
"address_2": "UNIT 450",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212202946",
"telephone_number": "717-487-2573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAUGHERTY",
"first_name": "BRANDI",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-25",
"last_updated": "2013-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "14260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.