Active NPI
Stephanie Kay Dudley, LCSW-C
- Clinical Social Worker
- Salisbury, MD
National Provider Identifier
1235487059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 18380
- Practice address
- 2336 Goddard Pkwy
Salisbury, MD 21801-1126 - Phone
- (410) 334-6961
- Fax
- (410) 334-6362
- NPI assigned
- Aug 28, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 18380 | MD | Primary |
| School Social Worker | 1041S0200X | 18380 | MD | |
| Social Worker | 104100000X | 18380 | MD |
Addresses
Primary practice location
2336 Goddard Pkwy
Salisbury, MD 21801-1126
Mailing address
2336 Goddard Pkwy
Salisbury, MD 21801-1126
Phone (410) 334-6961
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 522156095 | Other | MD | COMMERCIAL INS |
| 7840093 | Other | MD | AETNA |
| R968 | Other | MD | CAREFIRST HMO |
| 609550001 | Medicaid | MD | |
| 346646 | Other | MHN/TRICARE | |
| LM49EA | Other | MD | CAREFIRST LOCAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18380 | MD | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Behavioral Health, LLC | Current | Accepting new patients |
Locations
426 Dorchester Ave
Cambridge, MD 21613
Phone (410) 228-3929
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.
-
- Community/Behavioral Health Agency
- Easton, MD
- NPI 1174161087
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441152000000",
"number": "1235487059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2336 GODDARD PKWY",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218011126",
"telephone_number": "410-334-6961",
"fax_number": "410-334-6362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2336 GODDARD PKWY",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218011126",
"telephone_number": "410-334-6961",
"fax_number": "410-334-6362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDLEY",
"first_name": "STEPHANIE",
"middle_name": "KAY",
"credential": "LCSW-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-28",
"last_updated": "2015-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "18380",
"primary": true
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "MD",
"license": "18380",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "18380",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL INS",
"identifier": "522156095",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7840093",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST HMO",
"identifier": "R968",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "609550001",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN/TRICARE",
"identifier": "346646",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST LOCAL",
"identifier": "LM49EA",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salisbury, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; 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.