Active NPI
Andrea Stokes Rackowski, LCSW-C
- Clinical Social Worker
- Lutherville, MD
National Provider Identifier
1134647746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 14055
- Practice address
- 1400 Front Ave. Suite 305
Lutherville, MD 21093 - Phone
- (443) 390-7843
- NPI assigned
- Sep 3, 2017
- Last updated
- Sep 3, 2017
- 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 | 14055 | MD | Primary |
Addresses
Primary practice location
1400 Front Ave. Suite 305
Lutherville, MD 21093
Mailing address
3743 Beech Ave
Baltimore, MD 21211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 6, 2024 through Nov 6, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14055 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504396800000",
"number": "1134647746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3743 BEECH AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 FRONT AVE. SUITE 305",
"city": "LUTHERVILLE",
"state": "MD",
"postal_code": "21093",
"telephone_number": "443-390-7843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RACKOWSKI",
"first_name": "ANDREA",
"middle_name": "STOKES",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-03",
"last_updated": "2017-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "14055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lutherville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.