Organization Active NPI

Design for Your Soul

  • Clinical Social Worker
  • Eldersburg, MD
National Provider Identifier
1407633928
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
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, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 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

Enrollment IDStateProvider typePAC IDDetails
O20231011003267 MD Part B Supplier - Clinic/Group Practice 7810342839 Receives reassigned benefits from 1 practitioner
Practice locations: Eldersburg, MD; Frederick, MD

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.