NPIMap

Organization Active NPI

Sovereign Consulting Group LLC

  • Clinical Social Worker
  • Waldorf, MD
National Provider Identifier
1225799547
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SOVEREIGN CONSULTING GROUP LLC
Practice address
11110 Mall Cir # 6301
Waldorf, MD 20603-1800
Phone
(240) 270-1183
NPI assigned
Jan 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
Shiretta Denise Warren, LCSW-CNPI 1407209968
Title
Clinical Social Worker
Phone
(240) 565-5885

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

11110 Mall Cir # 6301
Waldorf, MD 20603-1800

Mailing address

PO Box 6301
Waldorf, MD 20603-6301
Phone (240) 270-1183

National Provider Directory

National Provider Directory

Locations

11110 Mall Cir
#6301
Waldorf, MD 20603
Phone (240) 270-1183

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1225799547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6301",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206036301",
            "telephone_number": "240-270-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MALL CIR # 6301",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206031800",
            "telephone_number": "240-270-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN CONSULTING GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-08",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "SHIRETTA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "240-565-5885",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.