Individual provider Active NPI

David M Pridmore, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1295816528
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13182 Issued in MD
Practice address
209 W Fayette St
Room 536
Baltimore, MD 21201-3403
Phone
(410) 637-1333
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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 13182 MD Primary

Addresses

Primary practice location

209 W Fayette St
Room 536
Baltimore, MD 21201-3403

Mailing address

209 W Fayette St
Room 536
Baltimore, MD 21201-3403
Phone (410) 637-1333

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13182MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1295816528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W FAYETTE ST",
            "address_2": "ROOM 536",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212013403",
            "telephone_number": "410-637-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W FAYETTE ST",
            "address_2": "ROOM 536",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212013403",
            "telephone_number": "410-637-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDMORE",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; 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.