Individual provider Active NPI

John Beyer, LCSW-C

  • Clinical Social Worker
  • Ellicott City, MD
National Provider Identifier
1265847735
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06889 Issued in MD
Practice address
4905 Orchard Dr
Ellicott City, MD 21043-6724
Phone
(443) 812-8031
NPI assigned
Jun 24, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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 06889 MD Primary

Addresses

Primary practice location

4905 Orchard Dr
Ellicott City, MD 21043-6724

Mailing address

4905 Orchard Dr
Ellicott City, MD 21043-6724
Phone (443) 812-8031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06889MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1265847735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 ORCHARD DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436724",
            "telephone_number": "443-812-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 ORCHARD DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436724",
            "telephone_number": "443-812-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYER",
        "first_name": "JOHN",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "06889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; 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.