Individual provider Active NPI

Amanda Johnson

  • Clinical Social Worker
  • Gaithersburg, MD
National Provider Identifier
1639034515
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28456 Issued in MD
Practice address
610 E Diamond Ave Ste 100
Gaithersburg, MD 20877-5321
Phone
(301) 840-2000
NPI assigned
Dec 22, 2025
Last updated
Dec 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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 28456 MD Primary

Addresses

Primary practice location

610 E Diamond Ave Ste 100
Gaithersburg, MD 20877-5321

Mailing address

PO Box 791891
Baltimore, MD 21279-1891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260123000998 MD Practitioner - Clinical Social Worker 6305323049 Reassigns benefits to 2 organizations
I20260325000787 DC Practitioner - Clinical Social Worker 6305323049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

849 Fairmont Ave
Towson, MD 21286

849 Fairmont Ave
FL 5
Towson, MD 21286-2624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28456MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Community Services, Inc. CurrentSince Dec 14, 2025 Accepting new patients
Mosaic Community Services, Inc CurrentSince Dec 14, 2025 Accepting new patients

Locations

2225 N Charles St
Baltimore, MD 21218
Phone (410) 366-4360

210 Abrecht Pl
Frederick, MD 21701
Phone (301) 663-8263

610 E Diamond Ave
Ste 100
Gaithersburg, MD 20877
Phone (301) 840-2000

328 N Potomac St
Hagerstown, MD 21740
Phone (410) 740-1901

1925 Greenspring Dr
Timonium, MD 21093

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1766361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1639034515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791891",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212791891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E DIAMOND AVE STE 100",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208775321",
            "telephone_number": "301-840-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-22",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "28456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.