Organization Active NPI

Wired Differently Therapy LLC

  • Clinical Social Worker
  • Pikesville, MD
National Provider Identifier
1366215451
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WIRED DIFFERENTLY THERAPY LLC
Practice address
9256 Howard Square Dr
Pikesville, MD 21208-6348
Phone
(443) 212-8137
NPI assigned
Nov 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Authorized official

Name
Rebecca Gibson, LCSW-CNPI 1881289437
Title
Owner
Phone
(443) 212-8137

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

9256 Howard Square Dr
Pikesville, MD 21208-6348

Mailing address

1301 York Road, Ste 800
#1028
Lutherville, MD 21093
Phone (443) 212-8137

Other names 2

  • Wired Differently Doing business as
  • Wired Differently Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1366215451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 YORK ROAD, STE 800",
            "address_2": "#1028",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "21093",
            "telephone_number": "443-212-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9256 HOWARD SQUARE DR",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212086348",
            "telephone_number": "443-212-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIRED DIFFERENTLY THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-01",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-212-8137",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wired Differently",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wired Differently",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wired Differently Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.