Individual provider Active NPI

Brendaline Nettey, LMSW

  • Social Worker
  • Gaithersburg, MD
National Provider Identifier
1679189484
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
26293 Issued in MD
Practice address
604 S Frederick Ave Ste 211
Gaithersburg, MD 20877-1282
Phone
(410) 816-9540
NPI assigned
Sep 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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 26293 MD Primary

Addresses

Primary practice location

604 S Frederick Ave Ste 211
Gaithersburg, MD 20877-1282

Mailing address

11607 Drumcastle Ter
Germantown, MD 20876-5640
Phone (240) 377-7706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230412000092 DC Practitioner - Clinical Social Worker 9931574639 Reassigns benefits to 1 organization
I20241120002478 VA Practitioner - Clinical Social Worker 9931574639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Maryland School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manbir Takhar PCGroup PAC ID 0749206951, 41 clinicians

Practice addresses (Care Compare)

12321 Middlebrook Rd
Germantown, MD 20874-1591
Phone (301) 428-1070

14520 Richmond Hwy
Woodbridge, VA 22191-2808
Phone (301) 428-1070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Access P.C. Current Accepting new patients
Tru Health Group, PC Current Accepting new patients

Locations

12321 Middlebrook Rd
Ste 101
Germantown, MD 20874
Phone 3014281070260

12321 Middlebrook Rd
Ste 102
Germantown, MD 20874
Phone (301) 428-3192

7598 Telegraph Rd
Alexandria, VA 22315
Phone (703) 778-0400

531 E Market St
Ste D
Leesburg, VA 20176
Phone (301) 427-1070

1231 Wolf Rock Dr
Ste 185
Purcellville, VA 20132

1210 Wolf Rock Dr
Purcellville, VA 20132
Phone (310) 428-1070

25031 Riding Plz
Ste 115B
South Riding, VA 20152
Phone (571) 267-2350

22000 Dulles Retail Plz
Ste 132
Sterling, VA 20166
Phone (703) 962-4160

14520 Richmond Hwy
Woodbridge, VA 22191
Phone (703) 497-1234

Organizations & group practices 3

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": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1679189484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11607 DRUMCASTLE TER",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208765640",
            "telephone_number": "240-377-7706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S FREDERICK AVE STE 211",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771282",
            "telephone_number": "410-816-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETTEY",
        "first_name": "BRENDALINE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "26293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.