Individual provider Active NPI

John P O'Brien, LCSW-C

  • Clinical Social Worker
  • Frederick, MD
National Provider Identifier
1700137940
Registry record updated Sep 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14829 Issued in MD
Practice address
198 Thomas Johnson Dr
Ste 9
Frederick, MD 21702-4443
Phone
(301) 208-8900
Fax
(301) 208-8369
NPI assigned
Sep 27, 2012
Last updated
Sep 7, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 14829 MD Primary

Addresses

Primary practice location

198 Thomas Johnson Dr
Ste 9
Frederick, MD 21702-4443

Mailing address

198 Thomas Johnson Dr
Ste 9
Frederick, MD 21702-4443
Phone (301) 208-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20130404000512 MD Practitioner - Clinical Social Worker 6800031394 Practice locations: Frederick, MD
I20150605000761 DC Practitioner - Clinical Social Worker 6800031394 Reassigns benefits to 1 organization
Practice locations: Gaithersburg, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9426 Stewartown Rd
2F
Gaithersburg, MD 20879-1607
Phone (301) 208-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14829MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Meier Clinics of Maryland, L.L.C. Clinical CurrentSince Jan 31, 2018 Accepting new patients
Village Counselors LLC Past Accepting new patients

Locations

2100 Manchester Rd
Ste 1510
Wheaton, IL 60187
Phone (708) 653-1717

230 N Washington St
Ste 206
Rockville, MD 20850
Phone (301) 315-9009

Organizations & group practices 2

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": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504742400000",
    "number": "1700137940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 THOMAS JOHNSON DR",
            "address_2": "STE 9",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024443",
            "telephone_number": "301-208-8900",
            "fax_number": "301-208-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 THOMAS JOHNSON DR",
            "address_2": "STE 9",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024443",
            "telephone_number": "301-208-8900",
            "fax_number": "301-208-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-27",
        "last_updated": "2017-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.