Individual provider Active NPI

Tanesha Rochelle Mayo, LCSW-C

  • Clinical Social Worker
  • Silver Spring, MD
National Provider Identifier
1669785622
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15284 Issued in MD
Practice address
1620 Elton Rd
Suite 204
Silver Spring, MD 20903-1740
Phone
(301) 439-7191
NPI assigned
Jul 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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 15284 MD Primary

Addresses

Primary practice location

1620 Elton Rd
Suite 204
Silver Spring, MD 20903-1740

Mailing address

5455 Columbia Rd
Apt. 224
Columbia, MD 21044-5572
Phone (443) 319-5149

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
15284MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279584000000",
    "number": "1669785622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 COLUMBIA RD",
            "address_2": "APT. 224",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210445572",
            "telephone_number": "443-319-5149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 ELTON RD",
            "address_2": "SUITE 204",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209031740",
            "telephone_number": "301-439-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "TANESHA",
        "middle_name": "ROCHELLE",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-20",
        "last_updated": "2010-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; 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.