Active NPI
Bardett Danielle Nicholson-Premick, LCSW-C, C-SWHC
- Clinical Social Worker
- Baltimore, MD
National Provider Identifier
1669499554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 09561
- Practice address
- 10 N Greene St
Baltimore, MD 21201-1524 - Phone
- (410) 605-7266
- NPI assigned
- Jul 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 09561 | MD | Primary |
Addresses
Primary practice location
10 N Greene St
Baltimore, MD 21201-1524
Mailing address
4601 Charles Ave
Baltimore, MD 21206-2028
Phone (410) 866-7573
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
| License | State | Type | Specialty |
|---|---|---|---|
| 09561 | MD | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669499554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 CHARLES AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212062028",
"telephone_number": "410-866-7573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 N GREENE ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011524",
"telephone_number": "410-605-7266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON-PREMICK",
"first_name": "BARDETT",
"middle_name": "DANIELLE",
"credential": "LCSW-C, C-SWHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "09561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.