Individual provider Active NPI

Nneka L Jefferson, LICSW, LCSW-C, LCSW

  • Clinical Social Worker
  • Riverdale, MD
National Provider Identifier
1225466931
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14901 Issued in MD
Practice address
6200 Baltimore Ave Ste 300
Riverdale, MD 20737-1054
Phone
(571) 402-2816
NPI assigned
Oct 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904007092 VA
Clinical Social Worker 1041C0700X LC50078674 DC
Clinical Social Worker 1041C0700X 14901 MD Primary

Addresses

Primary practice location

6200 Baltimore Ave Ste 300
Riverdale, MD 20737-1054

Mailing address

6200 Baltimore Ave Ste 300
Riverdale, MD 20737-1054
Phone (571) 402-2816

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
I20250730003664 DC Practitioner - Clinical Social Worker 8426565656 Practice locations: Greenbelt, MD

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
My Time Therapy Services, LLC Clinical Current Accepting new patients

Locations

6200 Baltimore Ave
Ste 300
Riverdale Park, MD 20737
Phone (240) 243-3490

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": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1225466931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 BALTIMORE AVE STE 300",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371054",
            "telephone_number": "571-402-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 BALTIMORE AVE STE 300",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371054",
            "telephone_number": "571-402-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "NNEKA",
        "middle_name": "L",
        "credential": "LICSW, LCSW-C, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007092",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50078674",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, MD

Sources for this page

Verify at the official NPI Registry.