Active NPI
Mary S. Waterbury, L.C.S.W.-C
- Clinical Social Worker
- Silver Spring, MD
National Provider Identifier
1619169257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 07289-C
- Practice address
- 8201 16TH St
#910
Silver Spring, MD 20910-3240 - Phone
- (301) 588-5930
- NPI assigned
- Aug 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 07289-C | MD | Primary |
Addresses
Primary practice location
8201 16TH St
#910
Silver Spring, MD 20910-3240
Mailing address
8201 16TH St
#910
Silver Spring, MD 20910-3240
Phone (301) 588-5930
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080422000781 | DC | Practitioner - Clinical Social Worker | 8224116884 | Practice locations: Silver Spring, MD |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
8201 16TH St
Apt 910
Silver Spring, MD 20910-3251
Phone (301) 588-5930
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07289-C | MD | MD | Clinical Social Worker |
| 07289 | MD | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392163200000",
"number": "1619169257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8201 16TH ST",
"address_2": "#910",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209103240",
"telephone_number": "301-588-5930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8201 16TH ST",
"address_2": "#910",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209103240",
"telephone_number": "301-588-5930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERBURY",
"first_name": "MARY",
"middle_name": "S.",
"name_prefix": "Mrs.",
"credential": "L.C.S.W.-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-17",
"last_updated": "2014-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "07289-C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.