Active NPI
Shannon Stafford Herman Maple, LCSW-C
- Clinical Social Worker
- Bel Air, MD
National Provider Identifier
1427379866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 17635
- Practice address
- 2107 Laurel Bush Rd
Suite 209
Bel Air, MD 21015-6181 - Phone
- (443) 827-3463
- NPI assigned
- Jun 21, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | G13000 | MD | |
| Clinical Social Worker | 1041C0700X | 17635 | MD | Primary |
Addresses
Primary practice location
2107 Laurel Bush Rd
Suite 209
Bel Air, MD 21015-6181
Mailing address
2107 Laurel Bush Rd
Suite 209
Bel Air, MD 21015-6181
Phone (443) 827-3463
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G13000 | MD | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bay Counseling MD LLC | Past | Accepting new patients | |
| K & a Psych Associates | Clinical | Past | Accepting new patients |
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Bel Air, MD
- NPI 1619729837
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423785600000",
"number": "1427379866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2107 LAUREL BUSH RD",
"address_2": "SUITE 209",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210156181",
"telephone_number": "443-827-3463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2107 LAUREL BUSH RD",
"address_2": "SUITE 209",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210156181",
"telephone_number": "443-827-3463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAPLE",
"first_name": "SHANNON",
"middle_name": "STAFFORD HERMAN",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-21",
"last_updated": "2015-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "G13000",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "17635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bel Air, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.