Active NPI
Raven Spady, LCSW-C
- Mental Health Counselor
- Gwynn Oak, MD
National Provider Identifier
1700263142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 14370
- Practice address
- 3 Walden Cherry CT
Gwynn Oak, MD 21207-3938 - Phone
- (443) 691-6906
- NPI assigned
- May 6, 2015
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 14370 | MD | Primary |
Addresses
Primary practice location
3 Walden Cherry CT
Gwynn Oak, MD 21207-3938
Mailing address
3 Walden Cherry CT
Gwynn Oak, MD 21207-3938
Phone (443) 691-6906
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210908001291 | MD | Practitioner - Clinical Social Worker | 3779989314 | Practice locations: Baltimore, MD |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14370 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430870400000",
"number": "1700263142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 WALDEN CHERRY CT",
"city": "GWYNN OAK",
"state": "MD",
"postal_code": "212073938",
"telephone_number": "443-691-6906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 WALDEN CHERRY CT",
"city": "GWYNN OAK",
"state": "MD",
"postal_code": "212073938",
"telephone_number": "443-691-6906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPADY",
"first_name": "RAVEN",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-06",
"last_updated": "2015-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "14370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gwynn Oak, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; 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.