Individual provider Active NPI

Susan Patricia Egelanian, LCSW-C

  • Clinical Social Worker
  • Glen Burnie, MD
National Provider Identifier
1326314642
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17643 Issued in MD
Practice address
30 Greenway St NW Ste 5
Glen Burnie, MD 21061-3557
Phone
(410) 760-9079
NPI assigned
Mar 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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 17643 MD Primary

Addresses

Primary practice location

30 Greenway St NW Ste 5
Glen Burnie, MD 21061-3557

Mailing address

30 Greenway St NW Ste 5
Glen Burnie, MD 21061-3557
Phone (410) 760-9079

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
I20120709000212 MD Practitioner - Clinical Social Worker 7416112909 Practice locations: Annapolis, MD; Severna Park, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13 President Point Dr
Unit A2
Annapolis, MD 21403-2387
Phone (410) 224-2792

4 Riggs Ave
Severna Park, MD 21146-3804
Phone (410) 224-2792

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17643MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis the Mental Health Center, LLC CurrentSince Jan 29, 2023 Accepting new patients

Locations

30 Greenway St NW
Ste 5
Glen Burnie, MD 21061
Phone 41076090790

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333065600000",
    "number": "1326314642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 GREENWAY ST NW STE 5",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613557",
            "telephone_number": "410-760-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 GREENWAY ST NW STE 5",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613557",
            "telephone_number": "410-760-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGELANIAN",
        "first_name": "SUSAN",
        "middle_name": "PATRICIA",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-30",
        "last_updated": "2012-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.