Individual provider Active NPI

Estefany Larios, LCSW-C

  • Clinical Social Worker
  • Glenn Dale, MD
National Provider Identifier
1619549441
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
27405 Issued in MD
Practice address
12150 Annapolis Rd Ste 200
Glenn Dale, MD 20769-9183
Phone
(888) 694-0333
NPI assigned
Jul 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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 LC200003527 DC
Clinical Social Worker 1041C0700X 27405 MD Primary

Addresses

Primary practice location

12150 Annapolis Rd Ste 200
Glenn Dale, MD 20769-9183

Mailing address

12150 Annapolis Rd
Glenn Dale, MD 20769-9183
Phone (240) 994-6047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC200003527DCMDClinical Social Worker
27405MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1619549441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12150 ANNAPOLIS RD",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699183",
            "telephone_number": "240-994-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 ANNAPOLIS RD STE 200",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699183",
            "telephone_number": "888-694-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARIOS",
        "first_name": "ESTEFANY",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200003527",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "27405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenn Dale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.