Justin Scott Proctor, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16918 Issued in MD

Practice address

53 Avalon Ave
Dundalk, MD 21222-4847

Phone

(443) 208-4326

NPI assigned

May 17, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Post Acute Physician Partners LLCGroup PAC ID 8224353891, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Post Acute Physician Partners, LLC

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1710385554
  Medicare reassignment Care Compare group NPD
• Sage Hollow Health PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Shelton, CT
  • NPI 1003700071

  MD

  Medicare reassignment NPD
• One Promise Counseling and Education

  • Adult Mental Health Clinic/Center
  • Baltimore, MD
  • NPI 1295371078
  Medicare reassignment

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485475200000",
    "number": "1154614683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 AVALON AVE",
            "city": "DUNDALK",
            "state": "MD",
            "postal_code": "212224847",
            "telephone_number": "443-208-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 AVALON AVE",
            "city": "DUNDALK",
            "state": "MD",
            "postal_code": "212224847",
            "telephone_number": "443-208-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "JUSTIN",
        "middle_name": "SCOTT",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-17",
        "last_updated": "2017-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "16918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "16918",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barry Nmi Pickus, DDS
• Lyndee Rae Pirigyi
• Podiatry Associates, P.a.
• Grant Calloway Porter, PHARM.D.
• Priority Care Express LLC
• Providing Hope Psychiatric Rehabilitation Program
• PRP Learning Center of Baltimore
• Cameron Pullen, PA-C
• Jaclyn Elizabeth Purvis, DPT
• Push Behavioral Health, LLC

• Clinical Social Worker in Dundalk, MD
• Providers in Dundalk, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.

Verify at the official NPI Registry.