Individual provider Active NPI

Celeste Maurette Grudzien, LCSW-C

  • Clinical Social Worker
  • Salisbury, MD
National Provider Identifier
1528360567
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16561 Issued in MD
Practice address
560 Riverside Dr Ste A204
Salisbury, MD 21801-4704
Phone
(443) 358-6193
Fax
(443) 358-6197
NPI assigned
Nov 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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 16561 MD Primary

Addresses

Primary practice location

560 Riverside Dr Ste A204
Salisbury, MD 21801-4704

Mailing address

PO Box 1978
Salisbury, MD 21802-1978
Phone (410) 749-1015

Other identifiers 1

IdentifierTypeStateIssuer
119591300MedicaidMD

Other names 1

  • Celeste Maurette Sheridan Former name

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
I20140528001425 MD Practitioner - Clinical Social Worker 4789807306 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16561MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Three Lower Counties Community Services Inc Current 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": "1290556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1528360567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 RIVERSIDE DR STE A204",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218014704",
            "telephone_number": "443-358-6193",
            "fax_number": "443-358-6197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUDZIEN",
        "first_name": "CELESTE",
        "middle_name": "MAURETTE",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-24",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "16561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CELESTE",
            "last_name": "SHERIDAN",
            "middle_name": "MAURETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.