Individual provider Active NPI

Tanya Renee Manyweathers, LCSW-C

  • Clinical Social Worker
  • Pikesville, MD
National Provider Identifier
1437585569
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
18836 Issued in MD
Practice address
17 Warren Rd Ste 10B
Pikesville, MD 21208-5332
Phone
(410) 205-2464
Fax
(410) 205-2464
NPI assigned
Sep 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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 18836 MD Primary

Addresses

Primary practice location

17 Warren Rd Ste 10B
Pikesville, MD 21208-5332

Mailing address

7408 Campfield Rd
Pikesville, MD 21208-5818
Phone (410) 302-8857

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
18836MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Renewing Your Mind Inc. PastSince Dec 22, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1437585569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7408 CAMPFIELD RD",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212085818",
            "telephone_number": "410-302-8857",
            "fax_number": "410-205-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 WARREN RD STE 10B",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212085332",
            "telephone_number": "410-205-2464",
            "fax_number": "410-205-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANYWEATHERS",
        "first_name": "TANYA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-20",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "18836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.