Individual provider Active NPI

Susan Mary Smith, LCSW-C

  • Clinical Social Worker
  • Frederick, MD
National Provider Identifier
1699408559
Registry record updated Apr 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
27342 Issued in MD
Practice address
5100 Buckeystown Pike Ste 250
Frederick, MD 21704-8344
Phone
(301) 781-6199
NPI assigned
Jul 7, 2022
Last updated
Apr 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 27342 MD
Clinical Social Worker 1041C0700X 27342 MD Primary

Addresses

Primary practice location

5100 Buckeystown Pike Ste 250
Frederick, MD 21704-8344

Mailing address

5100 Buckeystown Pike Ste 250
Frederick, MD 21704-8344
Phone (301) 781-6199

Other practice location 1

2225 N Charles St
Baltimore, MD 21218-5778
Phone (410) 453-9553

Other identifiers 2

IdentifierTypeStateIssuer
1041C0700XMedicaidMD
27342OtherMDLICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250429001338 MD Practitioner - Clinical Social Worker 7416473889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Frederick Behavioral Health Services, LLCGroup PAC ID 1456873249, 8 clinicians

Practice addresses (Care Compare)

9861 Broken Land Pkwy
Suite 100
Columbia, MD 21046-3031
Phone (301) 321-8245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Behavioral Health Services, LLC Social Worker CurrentSince Apr 9, 2025 Accepting new patients

Locations

9861 Broken Land Pkwy
Ste 100
Columbia, MD 21046
Phone (301) 321-8245

5100 Buckeystown Pike
Ste 250
Frederick, MD 21704
Phone (301) 321-8245

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744416000000",
    "number": "1699408559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 BUCKEYSTOWN PIKE STE 250",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048344",
            "telephone_number": "301-781-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 BUCKEYSTOWN PIKE STE 250",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048344",
            "telephone_number": "301-781-6199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2225 N Charles St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212185778",
            "country_code": "US",
            "telephone_number": "410-453-9553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SUSAN",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2025-04-12",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "27342",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "27342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041C0700X",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "27342",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.