Individual provider Active NPI

Monekka Natazia Davis, LCSW-C

  • Clinical Social Worker
  • Elkridge, MD
National Provider Identifier
1619595477
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25997 Issued in MD
Practice address
6655 Santa Barbara Rd
Elkridge, MD 21075-7500
Phone
(866) 968-6342
NPI assigned
Jul 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.027790 IL
Clinical Social Worker 1041C0700X 0904017453 VA
Clinical Social Worker 1041C0700X 25997 MD Primary

Addresses

Primary practice location

6655 Santa Barbara Rd
Elkridge, MD 21075-7500

Mailing address

6655 Santa Barbara Rd
Elkridge, MD 21075-7500
Phone (866) 968-6342

Other identifiers 1

IdentifierTypeStateIssuer
119591300MedicaidMD

Other names 1

  • Monekka Council Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20251106003558 IL Practitioner - Clinical Social Worker 1355877911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 8574
Elkridge, MD 21075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.027790ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Calm Focus Therapy Clinical Current Accepting new patients
Backpack Medical Group, P.C. Social Worker CurrentSince Sep 28, 2024 Accepting new patients
Fort Health Medical Group PA Clinical Past Accepting new patients
Linnel Inc PastSince Sep 5, 2023 Accepting new patients

Locations

400 N Aberdeen St
Chicago, IL 60642

1453 N Rolling Rd
Catonsville, MD 21228
Phone (410) 455-5461

6655 Santa Barbara Rd
Unit 8574
Elkridge, MD 21075
Phone (301) 569-2227

Organizations & group practices 4

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": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1619595477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 SANTA BARBARA RD",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210757500",
            "telephone_number": "866-968-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 SANTA BARBARA RD",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210757500",
            "telephone_number": "866-968-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MONEKKA",
        "middle_name": "NATAZIA",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.027790",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904017453",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "25997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONEKKA",
            "last_name": "COUNCIL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elkridge, MD

Sources for this page

Verify at the official NPI Registry.