Individual provider Active NPI

Donna Neidecker, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1306084678
Registry record updated Jan 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10606 Issued in MD
Practice address
606 Hammonds LN
Suite U1-5
Baltimore, MD 21225-3301
Phone
(410) 789-9850
NPI assigned
Jan 26, 2009
Last updated
Jan 26, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2009

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 10606 MD Primary

Addresses

Primary practice location

606 Hammonds LN
Suite U1-5
Baltimore, MD 21225-3301

Mailing address

2 Pinetree CT
Baltimore, MD 21286-1646
Phone (410) 825-4041

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
I20060228000399 MD Practitioner - Clinical Social Worker 9032125083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kilgalen Associates PAGroup PAC ID 1557318854, 5 clinicians

Practice addresses (Care Compare)

1716 Harford Rd
Suite 204
Fallston, MD 21047-2699
Phone (410) 877-7207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10606MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kilgalen Associates PA Clinical CurrentSince Dec 27, 2011 Accepting new patients
Inspirit Counseling Services, Inc. Clinical PastSince Aug 21, 2012 Accepting new patients

Locations

1716 Harford Rd
Ste 204
Fallston, MD 21047
Phone (410) 877-7207

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232928000000",
    "number": "1306084678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PINETREE CT",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212861646",
            "telephone_number": "410-825-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 HAMMONDS LN",
            "address_2": "SUITE U1-5",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212253301",
            "telephone_number": "410-789-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIDECKER",
        "first_name": "DONNA",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-26",
        "last_updated": "2009-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.