Individual provider Active NPI

Sonja Mae Large, LMSW

  • Social Worker
  • Bethesda, MD
National Provider Identifier
1710582192
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
31756 Issued in MD
Practice address
6505 Democracy Blvd
Bethesda, MD 20817-1688
Phone
(240) 225-0522
NPI assigned
Dec 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Social Worker 104100000X 31756 MD Primary

Addresses

Primary practice location

6505 Democracy Blvd
Bethesda, MD 20817-1688

Mailing address

6505 Democracy Blvd
Bethesda, MD 20817-1688
Phone (240) 225-0522

Other practice location 1

16220 Frederick Rd Ste 310
Gaithersburg, MD 20877-4020
Phone (301) 345-1022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
31756MDMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1710582192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6505 DEMOCRACY BLVD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171688",
            "telephone_number": "240-225-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 DEMOCRACY BLVD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171688",
            "telephone_number": "240-225-0522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16220 Frederick Rd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Gaithersburg",
            "state": "MD",
            "postal_code": "208774020",
            "country_code": "US",
            "telephone_number": "301-345-1022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARGE",
        "first_name": "SONJA",
        "middle_name": "MAE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-02",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "31756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.