Individual provider Active NPI

Katelynn Mae Liptak, LCSW-C

  • Social Worker
  • Prince Frederick, MD
National Provider Identifier
1659868271
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
21853 Issued in MD
Practice address
975 Solomons Island Rd N
Prince Frederick, MD 20678-3917
Phone
(410) 535-5400
NPI assigned
Apr 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 21853 MD Primary

Addresses

Primary practice location

975 Solomons Island Rd N
Prince Frederick, MD 20678-3917

Mailing address

975 N. Solomons Island Rd.
Prince Frederick, MD 20678-9557
Phone (410) 535-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20211025003282 MD Practitioner - Clinical Social Worker 1850789801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Calvert County Health Department 19 clinicians

Practice addresses (Care Compare)

975 Solomons Island Rd N
Suite 119
Prince Frederick, MD 20678-0980
Phone 4105355400329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Psychiatric Services LLC CurrentSince Oct 9, 2021 Accepting new patients
Calvert County Health Department CurrentSince Sep 23, 2021 Accepting new patients
Advantage Psychiatric Services LLC CurrentSince Oct 9, 2021 Accepting new patients
Calvert County Health Department CurrentSince Sep 23, 2021 Accepting new patients

Locations

306 W Pulaski Hwy
Elkton, MD 21921
Phone 4106863629 ext. 417

910 Revolution St
Hvre de Grace, MD 21078
Phone (410) 919-9665

5024 Campbell Blvd
Ste A
Nottingham, MD 21236
Phone 4106863629110

280 Stafford Rd
Prince Frederick, MD 20678
Phone (410) 535-3079

493 Main St
Prince Frederick, MD 20678
Phone 4106863629601

975 Solomons Island Rd N
Prnc Frederck, MD 20678
Phone (410) 535-5400

975 Solomons Island Rd N
Ste 119
Prnc Frederck, MD 20678
Phone (410) 535-5400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1659868271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 N. SOLOMONS ISLAND RD.",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206789557",
            "telephone_number": "410-535-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SOLOMONS ISLAND RD N",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783917",
            "telephone_number": "410-535-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPTAK",
        "first_name": "KATELYNN",
        "middle_name": "MAE",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-19",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "21853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

Verify at the official NPI Registry.