Age Well Takoma LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

AGE WELL TAKOMA LLC

Practice address

22 Sherman Ave
Takoma Park, MD 20912-5742

Phone

(301) 785-4998

NPI assigned

Dec 7, 2020

Organization subpart

No

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

Authorized official

Name

Kathleen Garber, LICSW, LCSW-CNPI 1326572298

Title

Founder and Principal

Phone

(301) 785-4998

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathleen Garber, LCSW-C

  • Clinical Social Worker
  • Takoma Park, MD
  • NPI 1326572298
  NPD Authorized official

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1255937173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 SHERMAN AVE",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209125742",
            "telephone_number": "301-785-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 SHERMAN AVE",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209125742",
            "telephone_number": "301-785-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGE WELL TAKOMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "GARBER",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "FOUNDER AND PRINCIPAL",
        "authorized_official_telephone_number": "301-785-4998",
        "authorized_official_credential": "LICSW, LCSW-C"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Suratu Ajoke Afolabi
• Frankline Agbor
• Ndidi R. Agholor, M.D.
• Michael Aghoogah
• Iris Nadia Agossou
• Jose Adalid Aguiluz Salazar, RN
• Bernice Aidoo, MD

• Community/Behavioral Health Agency in Takoma Park, MD
• Providers in Takoma Park, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.