Individual provider Active NPI

Tylah Victoria Stevens, MSW, LICSW, LCSW-C

  • Clinical Social Worker
  • Waldorf, MD
National Provider Identifier
1346880747
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24795 Issued in MD
Practice address
3261 Old Washington Rd Ste 3021
Waldorf, MD 20602-3229
Phone
(240) 280-3245
NPI assigned
Jan 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC50081842 DC
Clinical Social Worker 1041C0700X 0904011456 VA
Clinical Social Worker 1041C0700X 24795 MD Primary

Addresses

Primary practice location

3261 Old Washington Rd Ste 3021
Waldorf, MD 20602-3229

Mailing address

3261 Old Washington Rd Ste 3021
Waldorf, MD 20602-3229
Phone (240) 280-3245

Other practice location 1

16701 Melford Blvd Ste 400
Bowie, MD 20715-4411
Phone (415) 424-4266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20250331003307 DC Practitioner - Clinical Social Worker 8527581529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Howard University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

110 Irving St NW
Washington, DC 20010-3017
Phone (202) 877-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904011456VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jan 26, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jan 26, 2025 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

3007 Tilden St NW
Ste 5N
Washington, DC 20008

Organizations & group practices 2

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": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1346880747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3261 OLD WASHINGTON RD STE 3021",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023229",
            "telephone_number": "240-280-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3261 OLD WASHINGTON RD STE 3021",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023229",
            "telephone_number": "240-280-3245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16701 Melford Blvd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Bowie",
            "state": "MD",
            "postal_code": "207154411",
            "country_code": "US",
            "telephone_number": "415-424-4266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "TYLAH",
        "middle_name": "VICTORIA",
        "name_prefix": "Mrs.",
        "credential": "MSW, LICSW, LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50081842",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011456",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "24795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.