NPIMap

Organization Active NPI

Pyramid Walden LLC

  • Clinical Social Worker
  • Waldorf, MD
National Provider Identifier
1306128434
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PYRAMID WALDEN LLC
Practice address
85 High St
Suite 4
Waldorf, MD 20602-2150
Phone
(888) 912-7366
Fax
(301) 290-0280
NPI assigned
Sep 14, 2011
Last updated
Apr 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jason Hendricks
Title
Chief Executive Officer
Phone
(814) 940-0407

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

85 High St
Suite 4
Waldorf, MD 20602-2150

Mailing address

30007 Business Center Dr
Charlotte Hall, MD 20622-3101
Phone (301) 997-1300

Other identifiers 1

IdentifierTypeStateIssuer
613202200MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Pyramid Walden LLC18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

30007 Business Center Dr
Charlotte Hall, MD 20622

NPI Registry JSON

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1306128434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30007 BUSINESS CENTER DR",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206223101",
            "telephone_number": "301-997-1300",
            "fax_number": "301-863-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HIGH ST",
            "address_2": "SUITE 4",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022150",
            "telephone_number": "888-912-7366",
            "fax_number": "301-290-0280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PYRAMID WALDEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-14",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "814-940-0407"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "613202200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.