Individual provider Active NPI

Omira Lee, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1497792642
Registry record updated Nov 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
07228 Issued in MD
Practice address
2702 Allendale Rd
Baltimore, MD 21216-2133
Phone
(410) 664-4758
Fax
(410) 664-9399
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2007

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 07228 MD Primary

Addresses

Primary practice location

2702 Allendale Rd
Baltimore, MD 21216-2133

Mailing address

2702 Allendale Rd
Baltimore, MD 21216-2133
Phone (410) 664-4758

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120106000687 MD Practitioner - Clinical Social Worker 1456527779 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07228MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Traditional and Spiritual Counseling, Inc. Clinical CurrentSince Nov 5, 2000 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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1497792642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 ALLENDALE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162133",
            "telephone_number": "410-664-4758",
            "fax_number": "410-664-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 ALLENDALE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162133",
            "telephone_number": "410-664-4758",
            "fax_number": "410-664-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "OMIRA",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "07228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.