Individual provider Active NPI

Laura Teresa Begosh Funkhouser, LCSW-C

  • Clinical Social Worker
  • Gaithersburg, MD
National Provider Identifier
1477959799
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14208 Issued in MD
Practice address
16220 Frederick Rd
Suite 502
Gaithersburg, MD 20877-4039
Phone
(240) 423-8040
NPI assigned
Nov 13, 2014
Last updated
Apr 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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 14208 MD Primary

Addresses

Primary practice location

16220 Frederick Rd
Suite 502
Gaithersburg, MD 20877-4039

Mailing address

16220 Frederick Rd
Suite 502
Gaithersburg, MD 20877-4039
Phone (202) 827-5830

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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

LicenseStateTypeSpecialty
14208MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
DMV Mental Health, LLC Clinical Current 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1477959799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16220 FREDERICK RD",
            "address_2": "SUITE 502",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208774039",
            "telephone_number": "202-827-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16220 FREDERICK RD",
            "address_2": "SUITE 502",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208774039",
            "telephone_number": "240-423-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNKHOUSER",
        "first_name": "LAURA",
        "middle_name": "TERESA BEGOSH",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-13",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "16220 Frederick Rd",
            "address_2": "Suite 502",
            "city": "Gaithersburg",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208774039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.