Mary K Van Dommelen, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

26228 Issued in MD

Practice address

1741 Ashland Ave
Baltimore, MD 21205-1531

Phone

(443) 923-2800

NPI assigned

Oct 13, 2016

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Kennedy Krieger Associates

  • Pediatrics Physician
  • Middle River, MD
  • NPI 1841009842
  NPD
• Kennedy Krieger Associates

  • Pediatrics Physician
  • Baltimore, MD
  • NPI 1871515783
  NPD

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1316497316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 ASHLAND AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 ASHLAND AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051531",
            "telephone_number": "443-923-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DOMMELEN",
        "first_name": "MARY",
        "middle_name": "K",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "26228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Value Drugstore Harford Rd
• Vamhcs
• Jillayne Van Den Brink, LGSW
• Barbara Van Der Vossen, LGPC
• Brittany Van Devander, LCSW-C
• Van Dyke and Bacon Inc.
• Katlyn Bostic Van Dyke, AU.D.
• Van E. Lomis, MD LLC
• Kathryn Van Eck
• Amy Van Ee

• Clinical Social Worker in Baltimore, MD
• Providers in Baltimore, 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 Apr 24, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.