Vivian Archibong, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16212 Issued in MD

Practice address

2225 N Charles St
Baltimore, MD 21218-5778

Phone

(410) 453-9553

NPI assigned

May 24, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Citywide Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
  • NPI 1881100857
  Medicare reassignment NPD
• Family Health Centers of Baltimore, Inc.

  • Federally Qualified Health Center (FQHC)
  • Baltimore, MD
  • NPI 1205013539
  Medicare reassignment NPD
• KTS Mental Health Group, Inc

  • Professional Counselor
  • Parkville, MD
  • NPI 1982192977
  Medicare reassignment NPD
• Mosaic Community Services, Inc.

  • Adult Mental Health Clinic/Center
  • Timonium, MD
  • NPI 1265539142
  Medicare reassignment NPD
• Citywide Health Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • Pikesville, MD
  • NPI 1417595588
  NPD
• Family Health Centers of Baltimore

  • Federally Qualified Health Center (FQHC)
  • Baltimore, MD
  • NPI 1346286713
  NPD
• KTS Mental Health Group, Inc

  • Community/Behavioral Health Agency
  • Parkville, MD
  • NPI 1467049155
  NPD
• Mosaic Community Services, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Gaithersburg, MD
  • NPI 1710466313
  NPD
• Mosaic Community Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Belcamp, MD
  • NPI 1629420583
  NPD

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1235340266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 GREENSPRING DR",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210934128",
            "telephone_number": "410-453-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185778",
            "telephone_number": "410-453-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHIBONG",
        "first_name": "VIVIAN",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "16212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Archibald Optimal Health Services, LLC
• Paul Clifford Archibald, MA, LCSW-C
• Jamie Archibong, M.A.
• Eyamba Archibong, LCSW-C
• Samantha Ann Archibong, CRNP-PMH
• Kendarae Archie
• Terrell Devonne Archie
• Ard Behavioral Health
• Ard Behavioral Health
• Reena Ardeshna, M.D.

• Clinical Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.