Individual provider Active NPI

Jodi Vanderhorst, LCSW-C

  • Clinical Social Worker
  • Owings Mills, MD
National Provider Identifier
1417235169
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17270 Issued in MD
Practice address
119 Willow Bend Dr
Owings Mills, MD 21117-2619
Phone
(443) 974-7153
NPI assigned
Jul 29, 2011
Last updated
Jul 29, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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 17270 MD Primary

Addresses

Primary practice location

119 Willow Bend Dr
Owings Mills, MD 21117-2619

Mailing address

119 Willow Bend Dr
Owings Mills, MD 21117-2619
Phone (443) 974-7153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17270MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1417235169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 WILLOW BEND DR",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211172619",
            "telephone_number": "443-974-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 WILLOW BEND DR",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211172619",
            "telephone_number": "443-974-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERHORST",
        "first_name": "JODI",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-29",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; 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.