Active NPI
Bradley Dean Wofford, LCSWC
- Clinical Social Worker
- Germantown, MD
National Provider Identifier
1295161479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11511
- Practice address
- 18 Executive Park CT
Germantown, MD 20874-2645 - Phone
- (301) 428-3557
- Fax
- (301) 972-6635
- NPI assigned
- Sep 19, 2013
- Sex
- Male
- Sole proprietor
- No
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 | 11511 | MD | Primary |
Addresses
Primary practice location
18 Executive Park CT
Germantown, MD 20874-2645
Mailing address
18 Executive Park CT
Germantown, MD 20874-2645
Phone (301) 428-3557
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11511 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487548800000",
"number": "1295161479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 EXECUTIVE PARK CT",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208742645",
"telephone_number": "301-428-3557",
"fax_number": "301-972-6635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 EXECUTIVE PARK CT",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208742645",
"telephone_number": "301-428-3557",
"fax_number": "301-972-6635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOFFORD",
"first_name": "BRADLEY",
"middle_name": "DEAN",
"credential": "LCSWC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-19",
"last_updated": "2017-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "11511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Germantown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.