Ingrid Manfredo

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

INGRID MANFREDO

Practice address

178 Thomas Johnson Dr
Suite 205
Frederick, MD 21702-4386

Phone

(301) 639-1545

NPI assigned

May 11, 2015

Last updated

May 11, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ingrid Manfredo, LCSW-C, LCADCNPI 1235572835

Title

Owner

Phone

(301) 639-1545

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ingrid Jones Manfredo, LCSW-C, LCADC

  • Clinical Social Worker
  • Frederick, MD
  • NPI 1235572835
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1720466725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1473",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217020473",
            "telephone_number": "301-639-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 THOMAS JOHNSON DR",
            "address_2": "SUITE 205",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024386",
            "telephone_number": "301-639-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGRID MANFREDO",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "MANFREDO",
        "authorized_official_first_name": "INGRID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-639-1545",
        "authorized_official_credential": "LCSW-C, LCADC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Frederick, MD
• Providers in Frederick, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.