Active NPI
David Shrank I, LCSW-C, LICSW
- Clinical Social Worker
- Hyattsville, MD
National Provider Identifier
1174078448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 19015
- Practice address
- 6475 New Hampshire Ave # C700
Hyattsville, MD 20783-3269 - Phone
- (240) 565-2558
- NPI assigned
- Aug 16, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC50080481 | DC | |
| Clinical Social Worker | 1041C0700X | 19015 | MD | Primary |
Addresses
Primary practice location
6475 New Hampshire Ave # C700
Hyattsville, MD 20783-3269
Mailing address
1217 Arcola Ave
Silver Spring, MD 20902-3407
Phone (240) 565-2558
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- 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 |
|---|---|---|---|---|
| I20200302000684 | DC | Practitioner - Clinical Social Worker | 6507293644 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC50080481 | DC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empowerment Behavioral Therapeutic Services | Current | Accepting new patients | |
| Empowerment Behavioral Therapeutic Services LLC | Past | Accepting new patients |
Locations
6475 New Hampshire Ave
#C700
Hyattsville, MD 20783
Phone (215) 801-7893
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Hyattsville, MD
- NPI 1629856489
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Hyattsville, MD
- NPI 1376317792
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694563200000",
"number": "1174078448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1217 ARCOLA AVE",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209023407",
"telephone_number": "240-565-2558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6475 NEW HAMPSHIRE AVE # C700",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207833269",
"telephone_number": "240-565-2558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHRANK",
"first_name": "DAVID",
"name_suffix": "I",
"credential": "LCSW-C, LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-16",
"last_updated": "2023-09-13",
"certification_date": "2023-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LC50080481",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "19015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hyattsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.