Individual provider Active NPI

Anne McCauley Waller, LCSW-C, MSW

  • Clinical Social Worker
  • Ellicott City, MD
National Provider Identifier
1659548741
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
08094 Issued in MD
Practice address
5074 Dorsey Hall Dr
Suite 104
Ellicott City, MD 21042-7792
Phone
(410) 718-2229
NPI assigned
May 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2008

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 08094 MD Primary

Addresses

Primary practice location

5074 Dorsey Hall Dr
Suite 104
Ellicott City, MD 21042-7792

Mailing address

11800 Linden Chapel Rd
Clarksville, MD 21029-1127
Phone (410) 718-2229

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

LicenseStateTypeSpecialty
08094MDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1659548741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 LINDEN CHAPEL RD",
            "city": "CLARKSVILLE",
            "state": "MD",
            "postal_code": "210291127",
            "telephone_number": "410-718-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5074 DORSEY HALL DR",
            "address_2": "SUITE 104",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427792",
            "telephone_number": "410-718-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "ANNE",
        "middle_name": "MCCAULEY",
        "name_prefix": "Ms.",
        "credential": "LCSW-C, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "08094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.