Active NPI
Omolara Kasumu
- Clinical Social Worker
- Laurel, MD
National Provider Identifier
1699298489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 16878
- Practice address
- 14400 Mayfair Dr
Laurel, MD 20707-5206 - Phone
- (240) 838-2454
- NPI assigned
- Jul 24, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 16878 | MD | Primary |
Addresses
Primary practice location
14400 Mayfair Dr
Laurel, MD 20707-5206
Mailing address
14400 Mayfair Dr
Laurel, MD 20707-5206
Phone (240) 838-2454
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170927000449 | DC | Practitioner - Clinical Social Worker | 4284908443 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16878 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Behavioral Services, LLC | Clinical | Current | Accepting new patients |
Locations
1835 University Blvd E
Ste 316
Hyattsville, MD 20783
Phone (301) 270-3200
Organizations & group practices 1
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": "1500854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1699298489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14400 MAYFAIR DR",
"city": "LAUREL",
"state": "MD",
"postal_code": "207075206",
"telephone_number": "240-838-2454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14400 MAYFAIR DR",
"city": "LAUREL",
"state": "MD",
"postal_code": "207075206",
"telephone_number": "240-838-2454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASUMU",
"first_name": "OMOLARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-24",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "16878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.