Azalia Pettway, LCSWC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20296 Issued in MD

Practice address

1901 Lennox Dr
Eldersburg, MD 21784-6699

Phone

(443) 403-9597

NPI assigned

Aug 27, 2021

Last updated

Dec 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Empowerment Supports LLC

  • In Home Supportive Care Agency
  • Zebulon, NC
  • NPI 1346047149
  NPD Authorized official
• Inner Love Counseling, PLLC

  • Clinical Social Worker
  • Whitsett, NC
  • NPI 1184383929
  NPD Authorized official

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1669149506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6618 GLENVILLE DR",
            "city": "WHITSETT",
            "state": "NC",
            "postal_code": "273779141",
            "telephone_number": "443-403-9597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 LENNOX DR",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846699",
            "telephone_number": "443-403-9597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6618 Glenville Dr",
            "address_purpose": "LOCATION",
            "city": "Whitsett",
            "state": "NC",
            "postal_code": "273779141",
            "country_code": "US",
            "telephone_number": "443-403-9597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTWAY",
        "first_name": "AZALIA",
        "credential": "LCSWC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C014221",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "20296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy P. Passarello, D.D.S.
• Patapsco Acupuncture & Integrative Medicine
• Alana Pedigo
• Rhanee Perkins, DNP, CRNP, PMHNP-BC
• Edward Lee Perl, M.D.
• Brad Pfeffer, MD
• Amber Phelps
• Physicians Sleep Services (Eldersburg Eldercare)
• Physiotherapy Associates Inc (Physiotherapy Associates)
• Pivot Physical Therapy

• Clinical Social Worker in Eldersburg, MD
• Providers in Eldersburg, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.