Individual provider Active NPI

Denise Dianne Simmons, LCSW-C

  • Clinical Social Worker
  • New Freedom, PA
National Provider Identifier
1285749432
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
07572 Issued in MD
Practice address
764 Windy Hill Rd
New Freedom, PA 17349-8801
Phone
(410) 404-0705
NPI assigned
Aug 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 07572 MD Primary

Addresses

Primary practice location

764 Windy Hill Rd
New Freedom, PA 17349-8801

Mailing address

764 Windy Hill Rd
New Freedom, PA 17349-8801
Phone (410) 404-0705

Other names 1

  • Mrs. Denise Dianne Ippolito Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110223000174 MD Practitioner - Clinical Social Worker 3870774979 Practice locations: Lutherville, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9515 Deereco Rd
Suite 901
Lutherville, MD 21093-2160
Phone (443) 841-7355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07572MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285749432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 WINDY HILL RD",
            "city": "NEW FREEDOM",
            "state": "PA",
            "postal_code": "173498801",
            "telephone_number": "410-404-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 WINDY HILL RD",
            "city": "NEW FREEDOM",
            "state": "PA",
            "postal_code": "173498801",
            "telephone_number": "410-404-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "DENISE",
        "middle_name": "DIANNE",
        "name_prefix": "Miss",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "07572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "IPPOLITO",
            "middle_name": "DIANNE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Freedom, PA

Sources for this page

Verify at the official NPI Registry.