Jack Mangold, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11074 Issued in MD

Practice address

4804 Montgomery LN
Bethesda, MD 20814-5302

Phone

(240) 604-3744

NPI assigned

May 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• John William Mangold Other name

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 and National Provider Directory roles.

• Washington Assessment & Therapy Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kensington, MD
  • NPI 1689710022
  NPD (past)

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679781017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 MAPLE AVE",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208155111",
            "telephone_number": "240-604-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4804 MONTGOMERY LN",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208145302",
            "telephone_number": "240-604-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGOLD",
        "first_name": "JACK",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "11074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "MANGOLD",
            "middle_name": "WILLIAM",
            "credential": "LCSW-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kyle Evan Manetz, MD
• Alexander Peter Todd Mangerian
• Elisabeth Janelle Mangiagli
• Mia Mangione
• Alexis Rae Mango, DO
• Ralph Mangusan, NP
• Maura M Manion
• Mary Elizabeth Maniscalco-Theberge, M.D.
• Franco Joseph Maniscalco, CRNA
• Emerson Duyugan Maniwang, MD

• Clinical Social Worker in Bethesda, MD
• Providers in Bethesda, 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 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.

Verify at the official NPI Registry.