Mirta Elvire Innis-Thompson, LCSW-C,LICSW, DSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28198 Issued in MD

Practice address

11140 Rockville Pike Ste 480-E
North Bethesda, MD 20852-3106

Phone

(202) 763-9178

Fax

(240) 403-7629

NPI assigned

Feb 11, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Elite Behavioral Therapy

  • Clinical Social Worker
  • North Bethesda, MD
  • NPI 1992401376
  NPD Authorized official
• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1881717304
  NPD (past)
• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1952328700

  Clinical

  NPD (past)

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

{
    "created_epoch": "1360540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1386983393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12529 GREY FOX LN",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208541903",
            "telephone_number": "202-763-9178",
            "fax_number": "240-403-7582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11140 ROCKVILLE PIKE STE 480-E",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208523106",
            "telephone_number": "202-763-9178",
            "fax_number": "240-403-7629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12529 Grey Fox Ln",
            "address_purpose": "LOCATION",
            "city": "Potomac",
            "state": "MD",
            "postal_code": "208541903",
            "country_code": "US",
            "telephone_number": "240-338-0856",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10880 Wilshire Blvd Ste 1101",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900244112",
            "country_code": "US",
            "telephone_number": "202-763-9178",
            "fax_number": "240-403-7629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INNIS-THOMPSON",
        "first_name": "MIRTA",
        "middle_name": "ELVIRE",
        "credential": "LCSW-C,LICSW, DSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-11",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "200001933",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "28198",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "101906",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aiesha Darnelle Hogg, LCSW-C
• Kharia Jenai Holmes, MD
• Sandra Peisan Hsieh, D.D.S.
• Tony Hsu, D.D.S.
• Kathy Huang, M.D.
• Izere LLC
• Susan Jacobson, P.T.
• James J Flood DC PC
• Jason Paul Johnson, LCPC
• Howard Josefberg, MD

• Clinical Social Worker in North Bethesda, MD
• Providers in North Bethesda, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.