Individual provider Active NPI

Irene Michelle Mednick, L.C.S.W.

  • Social Worker
  • North Potomac, MD
National Provider Identifier
1174628846
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
16805 Issued in MD
Practice address
13809 Grey Colt Dr
North Potomac, MD 20878-3865
Phone
(512) 506-9614
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 38010 TX
Social Worker 104100000X 16805 MD Primary

Addresses

Primary practice location

13809 Grey Colt Dr
North Potomac, MD 20878-3865

Mailing address

13809 Grey Colt Dr
North Potomac, MD 20878-3865
Phone (512) 506-9614

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120130000651 DC Practitioner - Clinical Social Worker 0840299483 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jewish Social Service AgencyGroup PAC ID 8123920097, 22 clinicians

Practice addresses (Care Compare)

13809 Grey Colt Dr
North Potomac, MD 20878-3865
Phone (512) 569-9030

200 Wood Hill Rd
Rockville, MD 20850-8724
Phone 30183842002616

6123 Montrose Rd
Rockville, MD 20852-4860
Phone 30183842002616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New Chapter Counseling: Adult and Senior Mental Health Service, LLC Social Worker CurrentSince Aug 16, 2022 Accepting new patients
Jewish Social Service Agency CurrentSince Dec 21, 2011 Accepting new patients
Jewish Social Service Agency Social Worker CurrentSince Dec 21, 2011 Accepting new patients
Jewish Social Service Agency Social Worker Current Accepting new patients
Dr. Tania Glenn & Associates, P.a. Clinical Past Accepting new patients

Locations

6123 Montrose Rd
Rockville, MD 20852
Phone (301) 838-4200

200 Wood Hill Rd
Rockville, MD 20850
Phone (240) 800-5772

Organizations & group practices 5

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1174628846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13809 GREY COLT DR",
            "city": "NORTH POTOMAC",
            "state": "MD",
            "postal_code": "208783865",
            "telephone_number": "512-506-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13809 GREY COLT DR",
            "city": "NORTH POTOMAC",
            "state": "MD",
            "postal_code": "208783865",
            "telephone_number": "512-506-9614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDNICK",
        "first_name": "IRENE",
        "middle_name": "MICHELLE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "38010",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "16805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Potomac, MD

Sources for this page

Verify at the official NPI Registry.