Individual provider Active NPI

Brandon F Williams, LCSW-C

  • Social Worker
  • Glen Burnie, MD
National Provider Identifier
1730601873
Registry record updated Jul 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
22939 Issued in MD
Practice address
1406 Crain Hwy S
Glen Burnie, MD 21061-4058
Phone
(410) 766-6624
NPI assigned
Jul 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 22939 MD Primary

Addresses

Primary practice location

1406 Crain Hwy S
Glen Burnie, MD 21061-4058

Mailing address

1180 Sargeant St
Baltimore, MD 21223-3628
Phone (443) 851-7047

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
22939MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499731200000",
    "number": "1730601873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 SARGEANT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212233628",
            "telephone_number": "443-851-7047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 CRAIN HWY S",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614058",
            "telephone_number": "410-766-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRANDON",
        "middle_name": "F",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-11",
        "last_updated": "2017-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "22939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2017; 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.