Individual provider Active NPI

Rena Vanessa Arnold, LCSW-C

  • Clinical Social Worker
  • Hagerstown, MD
National Provider Identifier
1174808273
Registry record updated Feb 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17517 Issued in MD
Practice address
18714 N Village
Hagerstown, MD 21742-2454
Phone
(301) 733-0330
Fax
(301) 733-4038
NPI assigned
Oct 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 17517 MD Primary

Addresses

Primary practice location

18714 N Village
Hagerstown, MD 21742-2454

Mailing address

13121 Brooklane Dr
Hagerstown, MD 21742-1514
Phone (301) 733-0330

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120523000065 MD Practitioner - Clinical Social Worker 1850554262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brook Lane Behavioral Services, Inc.Group PAC ID 5991055022, 23 clinicians

Practice addresses (Care Compare)

1050 W Industrial Blvd
Cumberland, MD 21502-4331
Phone (301) 733-0300

13215 Brook Lane
Hagerstown, MD 21742-1514
Phone (301) 733-0330

18714 N Village
Hagerstown, MD 21742-2454
Phone (301) 733-0330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17517MDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Brook Lane Behavioral Services, Inc. Current Accepting new patients
Brook Lane Health Services, Inc. CurrentSince May 1, 2012 Accepting new patients

Locations

4540 Mack Ave
Ste B
Frederick, MD 21703
Phone (301) 698-5665

18714 North Village
Hagerstown, MD 21742
Phone (301) 733-0331

Organizations & group practices 3

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": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1174808273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13121 BROOKLANE DR",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217421514",
            "telephone_number": "301-733-0330",
            "fax_number": "301-733-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18714 N VILLAGE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217422454",
            "telephone_number": "301-733-0330",
            "fax_number": "301-733-4038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "RENA",
        "middle_name": "VANESSA",
        "name_prefix": "Miss",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.