Alicia Jefferson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19562 Issued in MD

Practice address

2670 Crain Hwy Ste 206
Waldorf, MD 20601-2816

Phone

(240) 535-4818

NPI assigned

Oct 20, 2016

Last updated

Oct 20, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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• Shine Behavioral Health, LLC

  dba Shine Wellness

  • Psychiatry Physician
  • Severna Park, MD
  • NPI 1255969713
  NPD (past)

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1265983670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 EASTHAM CT APT T3",
            "address_2": "CROFTON",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141043",
            "telephone_number": "240-535-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 CRAIN HWY STE 206",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206012816",
            "telephone_number": "240-535-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "ALICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "19562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jariwala Health Services LLC
• Cheryl Hamilton Jaworski, M.D.
• Joseph Edgar Jaworski,, PA-C
• Nirmaladevi Jayanthan, MD
• Jayanthan.M.D.,P.a
• Jamese Jefferson
• Linda Jefferson, MD
• Helen Anne Jenkins, RN, CDE
• Louise Greer Jenne, CRNP
• Jennifer Clancy Birth Services, LLC

• Clinical Social Worker in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.