Individual provider Active NPI

Jasmine Stock, LCSW-C

  • Clinical Social Worker
  • Aberdeen, MD
National Provider Identifier
1255784203
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20497 Issued in MD
Practice address
1040 Hardees Dr Ste F
Aberdeen, MD 21001-2665
Phone
(410) 273-1399
Fax
(410) 273-2085
NPI assigned
Jul 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 20497 MD Primary

Addresses

Primary practice location

1040 Hardees Dr Ste F
Aberdeen, MD 21001-2665

Mailing address

1925 Greenspring Dr
Timonium, MD 21093-4128
Phone (410) 453-9553

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201103002179 MD Practitioner - Clinical Social Worker 9739599762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mosaic Community Services, IncGroup PAC ID 0941289417, 63 clinicians

Practice addresses (Care Compare)

2225 N Charles St
Baltimore, MD 21218-5778
Phone (410) 938-5434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20497MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Community Services, Inc. Current Accepting new patients
Mosaic Community Services, Inc CurrentSince Aug 31, 2020 Accepting new patients
Mosaic Community Services, Inc. CurrentSince Aug 31, 2020 Accepting new patients
Mosaic Community Services, Inc. Past Accepting new patients

Locations

2225 N Charles St
Baltimore, MD 21218
Phone (410) 366-4360

210 Abrecht Pl
Frederick, MD 21701
Phone (301) 663-8263

1925 Greenspring Dr
Timonium, MD 21093

1931 Greenspring Dr
Timonium, MD 21093

Organizations & group practices 4

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": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1255784203",
    "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",
            "fax_number": "443-612-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 HARDEES DR STE F",
            "city": "ABERDEEN",
            "state": "MD",
            "postal_code": "210012665",
            "telephone_number": "410-273-1399",
            "fax_number": "410-273-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCK",
        "first_name": "JASMINE",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "20497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, MD

Sources for this page

Verify at the official NPI Registry.