Individual provider Active NPI

Amy Kestelman, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1558102756
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17187 Issued in MD
Practice address
150 Dumbarton Rd
Baltimore, MD 21212-1435
Phone
(608) 469-2266
NPI assigned
Jun 3, 2024
Last updated
Jun 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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 17187 MD Primary

Addresses

Primary practice location

150 Dumbarton Rd
Baltimore, MD 21212-1435

Mailing address

150 Dumbarton Rd
Baltimore, MD 21212-1435
Phone (608) 469-2266

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
I20240621001032 MD Practitioner - Clinical Social Worker 4880137686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oasis the Mental Health Center LLCGroup PAC ID 8527424837, 26 clinicians

Practice addresses (Care Compare)

1850 York Rd
Suite K
Timonium, MD 21093-5122
Phone (410) 760-9079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis the Mental Health Center, LLC CurrentSince Jun 1, 2024 Accepting new patients
Greater Baltimore Counseling Center, LLC Clinical PastSince Feb 1, 1996 Accepting new patients

Locations

30 Greenway St NW
Ste 5
Glen Burnie, MD 21061
Phone 41076090790

1850 York Rd
Ste K
Timonium, MD 21093
Phone (410) 410-7609

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, 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": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1558102756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 DUMBARTON RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212121435",
            "telephone_number": "608-469-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 DUMBARTON RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212121435",
            "telephone_number": "608-469-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESTELMAN",
        "first_name": "AMY",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.