Active NPI
George Lewis Carlson Jr., PH.D.,LCSW-C
- Clinical Social Worker
- Columbia, MD
National Provider Identifier
1346575297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 06899
- Practice address
- 8850 Columbia 100 Pkwy
Suite 403
Columbia, MD 21045-2374 - Phone
- (410) 730-0552
- Fax
- (410) 715-4720
- NPI assigned
- Oct 9, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 06899 | MD | Primary |
Addresses
Primary practice location
8850 Columbia 100 Pkwy
Suite 403
Columbia, MD 21045-2374
Mailing address
8850 Columbia 100 Pkwy
Suite 403
Columbia, MD 21045-2374
Phone (410) 730-0552
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective Oct 1, 2016 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06899 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380499200000",
"number": "1346575297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8850 COLUMBIA 100 PKWY",
"address_2": "SUITE 403",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210452374",
"telephone_number": "410-730-0552",
"fax_number": "410-715-4720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8850 COLUMBIA 100 PKWY",
"address_2": "SUITE 403",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210452374",
"telephone_number": "410-730-0552",
"fax_number": "410-715-4720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "GEORGE",
"middle_name": "LEWIS",
"name_suffix": "Jr.",
"credential": "PH.D.,LCSW-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-09",
"last_updated": "2013-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "06899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.