Active NPI
Design for Your Soul
- Clinical Social Worker
- Eldersburg, MD
National Provider Identifier
1407633928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- DESIGN FOR YOUR SOUL
- Practice address
- 6274 White Birch Rd
Eldersburg, MD 21784-8528 - Phone
- (410) 925-1422
- NPI assigned
- Sep 8, 2023
- Last updated
- Sep 8, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Marci Drimer-Jaffe
- Title
- Clinical Social Worker
- Phone
- (410) 925-1422
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
6274 White Birch Rd
Eldersburg, MD 21784-8528
Mailing address
6274 White Birch Rd
Eldersburg, MD 21784-8528
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
7819 Rocky Springs Rd
Frederick, MD 21702
Phone (301) 696-0808
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694131200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1694131200000",
"number": "1407633928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6274 WHITE BIRCH RD",
"city": "ELDERSBURG",
"state": "MD",
"postal_code": "217848528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6274 WHITE BIRCH RD",
"city": "ELDERSBURG",
"state": "MD",
"postal_code": "217848528",
"telephone_number": "410-925-1422"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DESIGN FOR YOUR SOUL",
"organizational_subpart": "NO",
"enumeration_date": "2023-09-08",
"last_updated": "2023-09-08",
"certification_date": "2023-09-08",
"status": "A",
"authorized_official_last_name": "DRIMER-JAFFE",
"authorized_official_first_name": "MARCI",
"authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
"authorized_official_telephone_number": "410-925-1422",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eldersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.