Deidre Odette McClellan, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

28224 Issued in MD

Practice address

107 E 25TH St
Baltimore, MD 21218-5213

Phone

(410) 558-0032

NPI assigned

Feb 16, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1548915788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7402 MAURY RD",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212444009",
            "telephone_number": "443-253-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E 25TH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185213",
            "telephone_number": "410-558-0032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7402 Maury Rd",
            "address_purpose": "LOCATION",
            "city": "Windsor Mill",
            "state": "MD",
            "postal_code": "212444009",
            "country_code": "US",
            "telephone_number": "443-253-2236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "DEIDRE",
        "middle_name": "ODETTE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "28224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John McClamrock
• Allene I McClary, RDH
• Herbert McClary
• Sharon McClean, MD
• Darren Taylor McCleary, LPTA
• Kierra McClellan
• Rebecca L McClellan, M.G.C.
• Jessica McClelland
• Azariya McClendon, DPM
• Sue V. McClintock, L.C.S.W.-C.

• Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.