Active NPI
Allen Carter Etty, MSW
- Social Worker
- Perry Point, MD
National Provider Identifier
1497854707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 03930
- Practice address
- Boiler House Road
Building 80H
Perry Point, MD 21902 - Phone
- (410) 642-2411
- NPI assigned
- Sep 22, 2006
- Last updated
- Aug 24, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 03930 | MD | Primary |
Addresses
Primary practice location
Boiler House Road
Building 80H
Perry Point, MD 21902
Mailing address
8 Heather CT
Newark, DE 19711-2768
Phone (410) 642-2411
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
| License | State | Type | Specialty |
|---|---|---|---|
| 03930 | MD | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251072000000",
"number": "1497854707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 HEATHER CT",
"city": "NEWARK",
"state": "DE",
"postal_code": "197112768",
"telephone_number": "410-642-2411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BOILER HOUSE ROAD",
"address_2": "BUILDING 80H",
"city": "PERRY POINT",
"state": "MD",
"postal_code": "21902",
"telephone_number": "410-642-2411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETTY",
"first_name": "ALLEN",
"middle_name": "CARTER",
"name_prefix": "Mr.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2009-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "03930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perry Point, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.