Individual provider Active NPI

Janice Nicole Doan, LCSW-C

  • Clinical Social Worker
  • Glen Burnie, MD
National Provider Identifier
1356867519
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15251 Issued in MD
Practice address
1406 Crain Hwy S Ste 104
Glen Burnie, MD 21061-4086
Phone
(410) 766-6624
NPI assigned
Aug 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 15251 MD Primary

Addresses

Primary practice location

1406 Crain Hwy S Ste 104
Glen Burnie, MD 21061-4086

Mailing address

1406 Crain Hwy S Ste 104
Glen Burnie, MD 21061-4086
Phone (410) 766-6624

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
I20170920002070 MD Practitioner - Clinical Social Worker 5799059374 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Behavioral Health, LLCGroup PAC ID 3476777947, 62 clinicians

Practice addresses (Care Compare)

5720 Executive Dr
Suite 100 105
Baltimore, MD 21228-1757
Phone (410) 780-5203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
M&M Behavioral Health Solutions CurrentSince Aug 20, 2017 Accepting new patients
Thrive Behavioral Health, LLC CurrentSince Apr 27, 2020 Accepting new patients
Thrive Behavioral Health, LLC Current Accepting new patients
M&M Behavioral Health Solutions Current Accepting new patients
Thrive Behavioral Health, LLC CurrentSince Apr 27, 2020 Accepting new patients

Locations

5720 Executive Dr
Ste 100105
Catonsville, MD 21228
Phone (443) 423-1656

1406 Crain Hwy S
Ste 104
Glen Burnie, MD 21061
Phone (410) 766-6624

1114 Benfield Blvd
Ste G
Millersville, MD 21108
Phone (410) 780-4320

9627 Philadelphia Rd
Ste 160
Rosedale, MD 21237
Phone (410) 780-5205

Organizations & group practices 5

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": "1503100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1356867519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 CRAIN HWY S STE 104",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614086",
            "telephone_number": "410-766-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 CRAIN HWY S STE 104",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614086",
            "telephone_number": "410-766-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOAN",
        "first_name": "JANICE",
        "middle_name": "NICOLE",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.