Individual provider Active NPI

Victoria Rodriguez, LCSW-C

  • Clinical Social Worker
  • Nottingham, MD
National Provider Identifier
1508247248
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
27885 Issued in MD
Practice address
5022 Campbell Blvd Ste L-M
Nottingham, MD 21236-4969
Phone
(443) 442-1568
NPI assigned
Jun 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 075080 NY
Clinical Social Worker 1041C0700X 27885 MD Primary

Addresses

Primary practice location

5022 Campbell Blvd Ste L-M
Nottingham, MD 21236-4969

Mailing address

5022 Campbell Blvd Ste L-M
Nottingham, MD 21236-4969
Phone (443) 442-1568

Other identifiers 1

IdentifierTypeStateIssuer
075080-1OtherNYNEW YORK STATE LICENSE

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
I20231004003392 MD Practitioner - Clinical Social Worker 8123473543

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aspire Wellness Center IncGroup PAC ID 2961685706, 41 clinicians

Practice addresses (Care Compare)

5022 Campbell Blvd
Suite L M
Nottingham, MD 21236-4969
Phone (443) 442-1568

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27885MDMDClinical Social Worker
075080NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Wellness Center, Inc. CurrentSince Sep 1, 2023 Accepting new patients

Locations

5022 Campbell Blvd
Ste Lm
Nottingham, MD 21236
Phone (443) 442-1568

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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1508247248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5022 CAMPBELL BLVD STE L-M",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364969",
            "telephone_number": "443-442-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5022 CAMPBELL BLVD STE L-M",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364969",
            "telephone_number": "443-442-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "VICTORIA",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075080",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "27885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE LICENSE",
            "identifier": "075080-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nottingham, MD

Sources for this page

Verify at the official NPI Registry.