Individual provider Active NPI

Charlene Fletcher, LICSW

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1407220981
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC50080237 Issued in DC
Practice address
1050 17TH St NW
Suite 800
Washington, DC 20036-5503
Phone
(301) 219-9051
Fax
(202) 529-3117
NPI assigned
Nov 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 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 14379 MD
Clinical Social Worker 1041C0700X LC50080237 DC Primary

Addresses

Primary practice location

1050 17TH St NW
Suite 800
Washington, DC 20036-5503

Mailing address

12223 Old Colony Dr
Upper Marlboro, MD 20772-5028
Phone (301) 219-9051

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
I20250219000254 DC Practitioner - Clinical Social Worker 4082134218 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC50080237DCMDClinical Social Worker
14379MDMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychogeriatric Services LLC Clinical CurrentSince Dec 3, 2024 Accepting new patients

Locations

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

Organizations & group practices 1

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": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1407220981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12223 OLD COLONY DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207725028",
            "telephone_number": "301-219-9051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 17TH ST NW",
            "address_2": "SUITE 800",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200365503",
            "telephone_number": "301-219-9051",
            "fax_number": "202-529-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "CHARLENE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-20",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14379",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50080237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.