Individual provider Active NPI

Rebecca Demattia, LGSW

  • Social Worker
  • Chestertown, MD
National Provider Identifier
1134550866
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
16141 Issued in MD
Practice address
114 S Lynchburg St Ste D
Chestertown, MD 21620-1128
Phone
(443) 331-4708
NPI assigned
Dec 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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 16141 MD Primary

Addresses

Primary practice location

114 S Lynchburg St Ste D
Chestertown, MD 21620-1128

Mailing address

114 S Lynchburg St Ste D
Chestertown, MD 21620-1128
Phone (443) 331-4708

Other practice location 1

207 N Liberty St
Centreville, MD 21617-1022
Phone (410) 758-8750 ext. 22

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
I20210520003112 MD Practitioner - Clinical Social Worker 4284033457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Discovering Serenity Counseling Services LLCGroup PAC ID 6103225370, 3 clinicians

Practice addresses (Care Compare)

208 Devon Dr
Chestertown, MD 21620-3348
Phone (443) 331-4708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16141MDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Discovering Serenity Counseling Services LLC Social Worker CurrentSince Jan 26, 2021 Accepting new patients

Locations

115 S Lynchburg St
Ste E
Chestertown, MD 21620
Phone (443) 331-4708

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.

NPI Registry JSON

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

{
    "created_epoch": "1386201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1134550866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 S LYNCHBURG ST STE D",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201128",
            "telephone_number": "443-331-4708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 S LYNCHBURG ST STE D",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201128",
            "telephone_number": "443-331-4708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 N Liberty St",
            "address_purpose": "LOCATION",
            "city": "Centreville",
            "state": "MD",
            "postal_code": "216171022",
            "country_code": "US",
            "telephone_number": "410-758-8750 x22",
            "fax_number": "410-758-8751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMATTIA",
        "first_name": "REBECCA",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-05",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "16141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestertown, MD

Sources for this page

Verify at the official NPI Registry.