Joan E. Pedersen, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10323 Issued in MD

Practice address

933-D Russell Avenue
Gaithersburg, MD 20879

Phone

(301) 527-1382

Fax

(301) 527-6158

NPI assigned

May 14, 2006

Sex

Female

Sole proprietor

Yes

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2013 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1147564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1336190339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933-D RUSSELL AVENUE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793290",
            "telephone_number": "301-527-1382",
            "fax_number": "301-527-6158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933-D RUSSELL AVENUE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "20879",
            "telephone_number": "301-527-1382",
            "fax_number": "301-527-6158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "JOAN",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-14",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peak Transit
• Carmen Peak, PSYCHOLOGY ASSOCIATE
• Tatiana Peal
• Tyrone Leeanthony Pearson
• Taleesa Peck, PH.D.
• Pediatric Dental Group,LLC
• Gregory Pelletier
• Pamela Pena-Lovo
• Sonia Caridad Pena
• Veronica Cristina Penaherrera

• Clinical Social Worker in Gaithersburg, MD
• Providers in Gaithersburg, 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 Jul 3, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.