Individual provider Active NPI

Wala Neh Aaron Labala, LCSW-C

  • Clinical Social Worker
  • Easton, MD
National Provider Identifier
1396832010
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14828 Issued in MD
Practice address
29520 Canvasback Dr
Easton, MD 21601-7124
Phone
(410) 822-5007
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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 14828 MD Primary

Addresses

Primary practice location

29520 Canvasback Dr
Easton, MD 21601-7124

Mailing address

2336 Goddard Pkwy
Salisbury, MD 21801-1126
Phone (410) 334-6961

Other identifiers 7

IdentifierTypeStateIssuer
517251OtherUHC MAMSI GROUP
609500300MedicaidMD
609500301MedicaidMD
R968-0045OtherMDBCBS-FEDERAL
609550002MedicaidMD
959421-01OtherMDBCBS-LOCAL
259147000OtherMDMAGELLAN GROUP

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
I20100806000258 MD Practitioner - Clinical Social Worker 9032242375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peace of Mind Mental Health Services LLCGroup PAC ID 6103047436, 13 clinicians

Practice addresses (Care Compare)

29315 Erickson Dr
Easton, MD 21601-8651
Phone (410) 690-8181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind Mental Health Services LLC Clinical CurrentSince Dec 30, 2015 Accepting new patients
Eastern Shore Psychological Service, LLC Past Accepting new patients

Locations

29315 Erickson Dr
Easton, MD 21601
Phone (410) 690-8181

8614 Ocean Gtwy
Ste 4
Easton, MD 21601
Phone (410) 690-8181

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1396832010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2336 GODDARD PKWY",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218011126",
            "telephone_number": "410-334-6961",
            "fax_number": "410-334-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29520 CANVASBACK DR",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216017124",
            "telephone_number": "410-822-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABALA",
        "first_name": "WALA NEH",
        "middle_name": "AARON",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC MAMSI GROUP",
            "identifier": "517251",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "609500300",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "609500301",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-FEDERAL",
            "identifier": "R968-0045",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "609550002",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-LOCAL",
            "identifier": "959421-01",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN GROUP",
            "identifier": "259147000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

Verify at the official NPI Registry.