Organization Active NPI

Pivots Potential LLC

  • Clinical Social Worker
  • Hagerstown, MD
National Provider Identifier
1659097525
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PIVOTS POTENTIAL LLC
Practice address
33 W Franklin St Ste 201
Hagerstown, MD 21740-4863
Phone
(888) 458-5199
Fax
(240) 337-8598
NPI assigned
Oct 12, 2022
Last updated
Jul 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Authorized official

Name
Vida Lynne Penn-Leon, LSCW
Title
Executive Officer
Phone
(240) 457-9505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

33 W Franklin St Ste 201
Hagerstown, MD 21740-4863

Mailing address

13606 Woodland Heights Dr
Hagerstown, MD 21742-2380
Phone (888) 458-5199

Other practice location 1

3900 Westerre Pkwy Ste 300
Richmond, VA 23233-1339
Phone (240) 457-9505

Other practice location 2

1209 Mountain Road Pl NE # 4433
Albuquerque, NM 87110-7845
Phone (240) 457-9505

Other practice location 3

5900 Balcones Dr # 16280
Austin, TX 78731-4257
Phone (888) 458-5199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20221104000649 MD Part B Supplier - Clinic/Group Practice 5799152724 Receives reassigned benefits from 1 practitioner
Practice locations: Hagerstown, MD
O20231009002108 VA Part B Supplier - Clinic/Group Practice 5799152724 Receives reassigned benefits from 3 practitioners
Practice locations: Glen Allen, VA

National Provider Directory

National Provider Directory

Locations

5900 Balcones Dr
#16280
Austin, TX 78731
Phone (888) 458-5199

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1659097525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13606 WOODLAND HEIGHTS DR",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217422380",
            "telephone_number": "888-458-5199",
            "fax_number": "240-337-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W FRANKLIN ST STE 201",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217404863",
            "telephone_number": "888-458-5199",
            "fax_number": "240-337-8598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 Westerre Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232331339",
            "country_code": "US",
            "telephone_number": "240-457-9505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1209 Mountain Road Pl NE # 4433",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871107845",
            "country_code": "US",
            "telephone_number": "240-457-9505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5900 Balcones Dr # 16280",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787314257",
            "country_code": "US",
            "telephone_number": "888-458-5199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PIVOTS POTENTIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A",
        "authorized_official_last_name": "PENN-LEON",
        "authorized_official_first_name": "VIDA LYNNE",
        "authorized_official_title_or_position": "EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "240-457-9505",
        "authorized_official_credential": "LSCW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 Jul 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.