Active NPI
Vicki Wasserman, LCSW-C
- Clinical Social Worker
- Lutherville, MD
National Provider Identifier
1154546034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11089
- Practice address
- 1300 York Rd
Suite #240B
Lutherville, MD 21093-6016 - Phone
- (410) 296-7277
- NPI assigned
- Apr 16, 2007
- 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 | 11089 | MD | Primary |
Addresses
Primary practice location
1300 York Rd
Suite #240B
Lutherville, MD 21093-6016
Mailing address
1300 York Rd
Suite #240B
Lutherville, MD 21093-6016
Phone (410) 296-7277
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100802000214 | MD | Practitioner - Clinical Social Worker | 4688707342 | Practice locations: Stevenson, MD |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
10421 Stevenson Rd
Unit 272
Stevenson, MD 21153-7511
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11089 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471824000000",
"number": "1154546034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 YORK RD",
"address_2": "SUITE #240B",
"city": "LUTHERVILLE",
"state": "MD",
"postal_code": "210936016",
"telephone_number": "410-296-7277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 YORK RD",
"address_2": "SUITE #240B",
"city": "LUTHERVILLE",
"state": "MD",
"postal_code": "210936016",
"telephone_number": "410-296-7277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASSERMAN",
"first_name": "VICKI",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2016-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "11089",
"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 Aug 22, 2016; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.