Active NPI
Gayle Bromberg, LCSW-C
- Clinical Social Worker
- Frederick, MD
National Provider Identifier
1235131293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 04118
- Practice address
- 170 Thomas Johnson Dr
Ste 210
Frederick, MD 21702-4354 - Phone
- (301) 695-8390
- Fax
- (301) 694-7906
- NPI assigned
- Jun 2, 2005
- Last updated
- Jul 13, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 04118 | MD | Primary |
Addresses
Primary practice location
170 Thomas Johnson Dr
Ste 210
Frederick, MD 21702-4354
Mailing address
170 Thomas Johnson Dr
Ste 210
Frederick, MD 21702-4354
Phone (301) 695-8390
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 239102 | Other | MD | MAMSI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 04118 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1235131293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 THOMAS JOHNSON DR",
"address_2": "STE 210",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217024354",
"telephone_number": "301-695-8390",
"fax_number": "301-694-7906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 THOMAS JOHNSON DR",
"address_2": "STE 210",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217024354",
"telephone_number": "301-695-8390",
"fax_number": "301-694-7906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROMBERG",
"first_name": "GAYLE",
"credential": "LCSW-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-02",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "04118",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "239102",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Frederick, MD
- Brilliant Birthing and Lactation, LLC
- Susan Barnett Brinkley, M.D.
- Kwadwo O Britwum
- Michelle L Britwum, BCBA, LBA
- David Bromberg, M.D.
- Jason Gabriel Bromer, M.D.
- Brook Lane Behavioral Services, Inc.
- Brook Lane Behavioral Services, Inc.
- Brook Lane Behavioral Services, Inc.
- Brook Lane Behavioral Services, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.