Active NPI
Janice Blackburn Mentzer
- Clinical Social Worker
- Hagerstown, MD
National Provider Identifier
1629656830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 08898
- Practice address
- 11116 Medical Campus Rd Ste 2989
Hagerstown, MD 21742-6710 - Phone
- (301) 766-7600
- Fax
- (301) 766-7702
- NPI assigned
- Mar 30, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 08898 | MD | Primary |
Addresses
Primary practice location
11116 Medical Campus Rd Ste 2989
Hagerstown, MD 21742-6710
Mailing address
11116 Medical Campus Rd Ste 2989
Hagerstown, MD 21742-6710
Phone (301) 766-7600
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
| License | State | Type | Specialty |
|---|---|---|---|
| 08898 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617062400000",
"number": "1629656830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11116 MEDICAL CAMPUS RD STE 2989",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217426710",
"telephone_number": "301-766-7600",
"fax_number": "301-766-7702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11116 MEDICAL CAMPUS RD STE 2989",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217426710",
"telephone_number": "301-766-7600",
"fax_number": "301-766-7702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENTZER",
"first_name": "JANICE",
"middle_name": "BLACKBURN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-30",
"last_updated": "2021-03-30",
"certification_date": "2021-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "08898",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hagerstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.