Khadejah McDougald, LCSW-C

Primary specialty

Social WorkerTaxonomy code 104100000X

License

23645 Issued in MD

Practice address

4200 Edmondson Ave Ste 202a
Baltimore, MD 21229-1614

Phone

(667) 205-1646

NPI assigned

Sep 26, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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 1

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Integrated Life Therapeutic Solutions

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1396423240

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• The Renewal Project

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Baltimore, MD
  • NPI 1932061819
  NPD Authorized official

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

{
    "created_epoch": "1632614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1689345993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 HARBERSON RD",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212281117",
            "telephone_number": "443-422-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 EDMONDSON AVE STE 202A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212291614",
            "telephone_number": "667-205-1646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOUGALD",
        "first_name": "KHADEJAH",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-26",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "MD",
            "license": "23645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Marie McDonnell
• Eileen McDonnell, MD
• Michelle Ann McDonnell, PA
• Peter McDonnell III
• Suzanne McDonough, PSY.D.
• Cameron G McDougall, MD
• Jenene McDowell
• Philip R. McDowell, M.D.
• Scott McDowell
• Toni Dominique McDowell, NURSE PRACTITIONER

• Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.