Individual provider Active NPI

David Forrest Rutherford, LCSWC MSSW

  • Social Worker
  • Hagerstown, MD
National Provider Identifier
1205924602
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
04938 Issued in MD
Practice address
1180 Professional Court
The Mental Health Center of Western Maryland Inc
Hagerstown, MD 21740
Phone
(301) 791-3405
Fax
(240) 313-3071
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 04938 MD Primary
Social Worker 104100000X CW013713 PA

Addresses

Primary practice location

1180 Professional Court
The Mental Health Center of Western Maryland Inc
Hagerstown, MD 21740

Mailing address

1180 Professional Court
Mental Health Center
Hagerstown, MD 21740
Phone (301) 791-3405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04938MDMDSocial Worker
CW013713PAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Franco Counseling Assoc PC Social Worker PastSince Jun 2, 2005 Accepting new patients

Organizations & group practices 1

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205924602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 PROFESSIONAL COURT",
            "address_2": "MENTAL HEALTH CENTER",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21740",
            "telephone_number": "301-791-3405",
            "fax_number": "301-714-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 PROFESSIONAL COURT",
            "address_2": "THE MENTAL HEALTH CENTER OF WESTERN MARYLAND INC",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21740",
            "telephone_number": "301-791-3405",
            "fax_number": "240-313-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "DAVID",
        "middle_name": "FORREST",
        "credential": "LCSWC MSSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "04938",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "CW013713",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.