Individual provider Active NPI

Stephanie Kay Dudley, LCSW-C

  • Clinical Social Worker
  • Salisbury, MD
National Provider Identifier
1235487059
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
18380 Issued in MD
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

Updated by the provider on Sep 2, 2015

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 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

IdentifierTypeStateIssuer
522156095OtherMDCOMMERCIAL INS
7840093OtherMDAETNA
R968OtherMDCAREFIRST HMO
609550001MedicaidMD
346646OtherMHN/TRICARE
LM49EAOtherMDCAREFIRST 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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18380MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Behavioral Health, LLC CurrentSince Aug 9, 2021 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.

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

Verify at the official NPI Registry.