Active NPI
Comfort Tetteh, LCSW-C
- Clinical Social Worker
- Gaithersburg, MD
National Provider Identifier
1265749527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 16786
- Practice address
- 501 N Frederick Ave
Ste 300
Gaithersburg, MD 20877-2507 - Phone
- (240) 561-2274
- Fax
- (301) 710-6540
- NPI assigned
- Sep 8, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 16786 | MD | Primary |
Addresses
Primary practice location
501 N Frederick Ave
Ste 300
Gaithersburg, MD 20877-2507
Mailing address
22940 Newcut Rd
Clarksburg, MD 20871-9307
Phone (240) 561-2274
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0661104 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120905000506 | MD | Practitioner - Clinical Social Worker | 6103073614 | Practice locations: Lexington Park, MD; Gaithersburg, MD |
| I20160922000341 | DC | Practitioner - Clinical Social Worker | 6103073614 | Practice locations: Gaithersburg, MD |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
12 S Summit Ave
Suite 100
Gaithersburg, MD 20877-2090
Phone (240) 561-2274
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16786 | MD | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473465600000",
"number": "1265749527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22940 NEWCUT RD",
"city": "CLARKSBURG",
"state": "MD",
"postal_code": "208719307",
"telephone_number": "240-561-2274",
"fax_number": "301-710-6540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 N FREDERICK AVE",
"address_2": "STE 300",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208772507",
"telephone_number": "240-561-2274",
"fax_number": "301-710-6540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TETTEH",
"first_name": "COMFORT",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-08",
"last_updated": "2016-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "16786",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0661104",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2016; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.