Individual provider Active NPI

Elissa Lopez Inthisane, MSW, LCSW-C

  • Clinical Social Worker
  • Bethesda, MD
National Provider Identifier
1710406004
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22371 Issued in MD
Practice address
8120 Woodmont Ave Ste 840
Bethesda, MD 20814-2789
Phone
(240) 618-2889
Fax
(240) 623-9858
NPI assigned
Sep 18, 2017
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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 22371 MD Primary

Addresses

Primary practice location

8120 Woodmont Ave Ste 840
Bethesda, MD 20814-2789

Mailing address

8120 Woodmont Ave Ste 840
Bethesda, MD 20814-2789
Phone (240) 618-2889

Other practice location 1

9420 Key West Ave Ste 430
Rockville, MD 20850-6371
Phone (301) 579-0089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20240212001044 DC Practitioner - Clinical Social Worker 9133562747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Mental Health LLCGroup PAC ID 6103294939, 14 clinicians

Practice addresses (Care Compare)

8120 Woodmont Ave
Suite 840
Bethesda, MD 20814-2789
Phone (240) 618-2889

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
One Mental Health LLC CurrentSince Dec 30, 2023 Accepting new patients

Locations

8120 Woodmont Ave
Ste 840
Bethesda, MD 20814
Phone (240) 618-2889

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": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1710406004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 WOODMONT AVE STE 840",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208142789",
            "telephone_number": "240-618-2889",
            "fax_number": "240-623-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8120 WOODMONT AVE STE 840",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208142789",
            "telephone_number": "240-618-2889",
            "fax_number": "240-623-9858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9420 Key West Ave Ste 430",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208506371",
            "country_code": "US",
            "telephone_number": "301-579-0089",
            "fax_number": "240-623-9858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INTHISANE",
        "first_name": "ELISSA",
        "middle_name": "LOPEZ",
        "credential": "MSW, LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "22371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.