Individual provider Active NPI

Andrea Clare Mazzarino, MSW, LCSW-C, PHD

  • Clinical Social Worker
  • Barnesville, MD
National Provider Identifier
1538649397
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24294 Issued in MD
Practice address
22611 Old Hundred Rd
Barnesville, MD 20838-9734
Phone
(401) 525-8858
NPI assigned
Aug 20, 2018
Last updated
May 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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 24294 MD Primary
Clinical Social Worker 1041C0700X 0904013602 VA

Addresses

Primary practice location

22611 Old Hundred Rd
Barnesville, MD 20838-9734

Mailing address

22611 Old Hundred Rd
Barnesville, MD 20838-9734
Phone (401) 525-8858

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Therapynotes.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20210429001127 DC Practitioner - Clinical Social Worker 8527477751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

22611 Old Hundred Rd
Barnesville, MD 20838-9734
Phone (401) 525-8858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0904013602VAMDClinical Social Worker
24294MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Monocacy Therapy LLC Clinical CurrentSince Nov 29, 2022 Accepting new patients

Locations

9301 Annapolis Rd
Ste 300
Lanham, MD 20706
Phone (240) 296-5848

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": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1538649397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22611 OLD HUNDRED RD",
            "city": "BARNESVILLE",
            "state": "MD",
            "postal_code": "208389734",
            "telephone_number": "401-525-8858",
            "fax_number": "401-525-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22611 OLD HUNDRED RD",
            "city": "BARNESVILLE",
            "state": "MD",
            "postal_code": "208389734",
            "telephone_number": "401-525-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZARINO",
        "first_name": "ANDREA",
        "middle_name": "CLARE",
        "name_prefix": "Dr.",
        "credential": "MSW, LCSW-C, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "24294",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904013602",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Therapynotes.com",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "22611 Old Hundred Rd",
            "city": "Barnesville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208389734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Barnesville, MD

Sources for this page

Verify at the official NPI Registry.