Sally Elizabeth Fogle, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

09168 Issued in MD

Practice address

11120 New Hampshire Ave
Suite 204
Silver Spring, MD 20904-2633

Phone

(301) 593-1315

Fax

(310) 681-4699

NPI assigned

Jan 25, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Safe Harbor Behavioral Care LLCGroup PAC ID 0345514675, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Safe Harbor Behavioral Care, LLC

  • Clinical Social Worker
  • Bel Air, MD
  • NPI 1316487879
  Medicare reassignment Care Compare group NPD
• Safe Harbor Christian Counseling LLC

  • Clinical Social Worker
  • Bel Air, MD
  • NPI 1245377894
  Medicare reassignment NPD
• Psychogeriatric Services LLC

  • Psychiatry Physician
  • Columbia, MD
  • NPI 1588689483

  DC

  Medicare reassignment

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

{
    "created_epoch": "1232841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1316185671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9549A BALTIMORE NATIONAL PIKE",
            "city": "MYERSVILLE",
            "state": "MD",
            "postal_code": "21773",
            "telephone_number": "240-452-0659",
            "fax_number": "310-681-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 NEW HAMPSHIRE AVE",
            "address_2": "SUITE 204",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042633",
            "telephone_number": "301-593-1315",
            "fax_number": "310-681-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGLE",
        "first_name": "SALLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-25",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "09168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raissa Fodjo
• Bradley Roger Foerster, M.D.
• Lillian Adele Foerster, CRNP-P
• Fatoumata D Fofana
• Charles J Fogelman, PH.D.
• Danielle Elizabeth Fogleman
• Juliette Fogwe
• Ashley Folts
• Annette Fombu, RN
• Charlotte Fomengia, LGPC

• Clinical Social Worker in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.