Individual provider Active NPI

Annette D. Levesque-Nieman, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1184795478
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12165 Issued in MD
Practice address
903 Edmondson Ave
Baltimore, MD 21228
Phone
(410) 455-0098
Fax
(410) 455-0098
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 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 12165 MD Primary

Addresses

Primary practice location

903 Edmondson Ave
Baltimore, MD 21228

Mailing address

903 Edmondson Ave
Baltimore, MD 21228-4408
Phone (410) 455-0098

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
I20040519000929 MD Practitioner - Clinical Social Worker 2668463670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ascension Counseling Services LLCGroup PAC ID 8022248087, 2 clinicians

Practice addresses (Care Compare)

903 Edmondson Ave
Catonsville, MD 21228-4408
Phone (410) 455-0098

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12165MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: annettelevesquenieman@tdh.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1184795478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 EDMONDSON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212284408",
            "telephone_number": "410-455-0098",
            "fax_number": "410-455-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 EDMONDSON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21228",
            "telephone_number": "410-455-0098",
            "fax_number": "410-455-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVESQUE-NIEMAN",
        "first_name": "ANNETTE",
        "middle_name": "D.",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.