Active NPI
Maureen Kennedy
- Clinical Social Worker
- Rockville, MD
National Provider Identifier
1285173393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 06063
- Practice address
- 12 S Adams St
Rockville, MD 20850-4238 - Phone
- (240) 731-5004
- NPI assigned
- Feb 22, 2017
- 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 | 06063 | MD | Primary |
Addresses
Primary practice location
12 S Adams St
Rockville, MD 20850-4238
Mailing address
12 S Adams St
Rockville, MD 20850-4238
Phone (240) 731-5004
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2019 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06063 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487721600000",
"number": "1285173393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 S ADAMS ST",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208504238",
"telephone_number": "240-731-5004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 S ADAMS ST",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208504238",
"telephone_number": "240-731-5004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "MAUREEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-22",
"last_updated": "2017-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "06063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.