Individual provider Active NPI

Amy Telep Dibos, LCSW-C

  • Clinical Social Worker
  • Towson, MD
National Provider Identifier
1457781791
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11979 Issued in MD
Practice address
7600 Osler Dr
Suite 213
Towson, MD 21204-7735
Phone
(410) 494-8778
NPI assigned
Nov 22, 2013
Last updated
Nov 22, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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 11979 MD Primary

Addresses

Primary practice location

7600 Osler Dr
Suite 213
Towson, MD 21204-7735

Mailing address

7600 Osler Dr
Suite 213
Towson, MD 21204-7735
Phone (410) 494-8778

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
11979MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1457781791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 OSLER DR",
            "address_2": "SUITE 213",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047735",
            "telephone_number": "410-494-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 OSLER DR",
            "address_2": "SUITE 213",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047735",
            "telephone_number": "410-494-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBOS",
        "first_name": "AMY",
        "middle_name": "TELEP",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-22",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "11979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.