Individual provider Active NPI

Arthur Douglas Jr., LCSW-C

  • Clinical Social Worker
  • Hagerstown, MD
National Provider Identifier
1609124569
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
18143 Issued in MD
Practice address
44 N Potomac St
Hagerstown, MD 21740-4855
Phone
(240) 354-6956
Fax
(301) 302-7384
NPI assigned
Aug 27, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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 18143 MD Primary

Addresses

Primary practice location

44 N Potomac St
Hagerstown, MD 21740-4855

Mailing address

44 N Potomac St Ste 103
Hagerstown, MD 21740-3301
Phone (301) 733-1500

Other identifiers 2

IdentifierTypeStateIssuer
1041C0700XMedicaidMD
1942650692MedicaidMD

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
I20150302001047 MD Practitioner - Clinical Social Worker 9638495013 Reassigns benefits to 1 organization
Practice locations: Hagerstown, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

44 N Potomac St
Suite 103
Hagerstown, MD 21740-3301
Phone (301) 733-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18143MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Strong Families Strong People, Inc. CurrentSince Oct 1, 2021 Accepting new patients

Locations

44 N Potomac St
Ste 103
Hagerstown, MD 21740
Phone (301) 733-1500

6 Public Sq
Ste 100
Hagerstown, MD 21740
Phone (240) 354-6956

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": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1609124569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 N POTOMAC ST STE 103",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217403301",
            "telephone_number": "301-733-1500",
            "fax_number": "301-733-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 N POTOMAC ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217404855",
            "telephone_number": "240-354-6956",
            "fax_number": "301-302-7384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "ARTHUR",
        "name_suffix": "Jr.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-27",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "18143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041C0700X",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942650692",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.