Individual provider Active NPI

Kathleen K Bogado, LCSW-C

  • Clinical Social Worker
  • Rockville, MD
National Provider Identifier
1659403053
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
887 Issued in MD
Practice address
11106 Ralston Rd
Rockville, MD 20852-3665
Phone
(301) 897-5588
Fax
(301) 897-5639
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 887 MD Primary

Addresses

Primary practice location

11106 Ralston Rd
Rockville, MD 20852-3665

Mailing address

11106 Ralston Rd
Rockville, MD 20852-3665
Phone (301) 897-5588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20120228000311 DC Practitioner - Clinical Social Worker 3476711094 Practice locations: Rockville, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11106 Ralston Rd
Rockville, MD 20852-3665
Phone (301) 897-5588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
887MDMDClinical Social Worker
00887MDMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659403053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11106 RALSTON RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523665",
            "telephone_number": "301-897-5588",
            "fax_number": "301-897-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11106 RALSTON RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523665",
            "telephone_number": "301-897-5588",
            "fax_number": "301-897-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGADO",
        "first_name": "KATHLEEN",
        "middle_name": "K",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.