Individual provider Active NPI

Victoria Ashade Cole, LCSW-C

  • Clinical Social Worker
  • Lanham, MD
National Provider Identifier
1386017911
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4500 Forbes Blvd Ste 200
Lanham, MD 20706-6316
Phone
(240) 815-2747
NPI assigned
Nov 4, 2015
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 20374 MD
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

4500 Forbes Blvd Ste 200
Lanham, MD 20706-6316

Mailing address

4500 Forbes Blvd Ste 200
Lanham, MD 20706-6316
Phone (240) 815-2747

Other identifiers 1

IdentifierTypeStateIssuer
103322100MedicaidMD

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
I20160302001161 DC Practitioner - Clinical Social Worker 7810293719 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kirstin's Haven, IncGroup PAC ID 2264778778, 3 clinicians

Practice addresses (Care Compare)

5801 Allentown Rd
Suite 310
Camp Springs, MD 20746-4564
Phone (240) 392-2876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20374MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kirstin's Haven, Inc CurrentSince Dec 5, 2018 Accepting new patients
Premier Health Care, LLC CurrentSince Jan 2, 2016 Accepting new patients
Premier Health Care LLC CurrentSince Jan 2, 2016 Accepting new patients

Locations

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

5801 Allentown Rd
Ste 310
Suitland, MD 20746
Phone (240) 392-2876

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1386017911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 FORBES BLVD STE 200",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207066316",
            "telephone_number": "240-815-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 FORBES BLVD STE 200",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207066316",
            "telephone_number": "240-815-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "VICTORIA",
        "middle_name": "ASHADE",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "20374",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103322100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

Verify at the official NPI Registry.